940 Matching Annotations
  1. Oct 2026
    1. 70 22 M 16 c.1946-1G.A Hmz 1.2 1 4 + -

      Case: 70, M, 22 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: family history of disease, Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 1.2, VWF:Ag (U/dl): 1, Bleeding Score: 4

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.1946-1G>A, Exon 16

      Homozygous

    2. 10 42 M 31 c.5335C.T p.R1779* Htz ,1 ,1 34 + -

      Case: 10, M, 42 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): <1, VWF:Ag (U/dl): <1, Bleeding Score: 34

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.5335C>T (p.Arg1779*), Exon 31, Heterozygous

    3. 18 8 M 47 c.7300C.T p.R2434* Hmz 8 4.6 8 - +

      Case: 18, M, 8 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes, no family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 8, VWF:Ag (U/dl): 4.6, Bleeding Score: 8

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.7300C>T (p.Arg2434*), Exon 47, Homozygous

      Note: Look over exon

    4. 23 10 F 8 c.954T.A p.N318K Htz 3.1 ,1 8 + +

      Case: 23, F, 10 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: family history of disease, Consanguinity: yes

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 3.1, VWF:Ag (U/dl): <1, Bleeding Score: 8

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.954T>A (p.Asn318Lys), Exon 8

      Heterozygous

    5. 62 5 F 50 c.8145C.Ap.C2715* Hmz 3.5 2.6 15 - +

      Case: 62, F, 5 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes, no family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 3.5, VWF:Ag (U/dl): 2.6, Bleeding Score: 15

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.8145C>A (p.Cys2715*), Exon 50, Homozygous

    6. 29 0.8 F 45 c.7558C.T p.Q2520* Hmz 1.6 1.8 3 + +

      Case: 29, F, 0.8 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 1.6, VWF:Ag (U/dl): 1.8, Bleeding Score: 3

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.7558C>T (p.Gln2520* ), Exon 45, Homozygous

    7. 15 29 M 31 c.5335C.T p.R1779* Hmz 1.8 ,1 16 + -

      Case: 15, M, 29 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 1.8, VWF:Ag (U/dl): <1, Bleeding Score: 16

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.5335C>T (p.Arg1779*), Exon 31, Homozygous

    8. 23 10 F 18 c.2430C.Ap.C810* Htz 3.1 ,1 8 + +

      Case: 23, F, 10 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 3.1, VWF:Ag (U/dl): <1, Bleeding Score: 8

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2430C>A (p.Cys810*), Exon 18, Heterozygous

    9. 12 16 F 31 c.5335C.T p.R1779* Hmz 6 ,1 16 + -

      Case: 12, F, 16 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): 6, VWF:Ag (U/dl): <1, Bleeding Score: 16

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.5335C>T (p.Arg1779*), Exon 31, Homozygous

    10. 20 10 M 45 c.7603C.T p.R2535* Hmz ,1 ,1 8 + -

      Case: 20, M, 10 years, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no, family history of disease

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: FVIII:C: (U/dl): <1, VWF:Ag (U/dl): <1, Bleeding Score: 8

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.7603C>T (p.Arg2535*), Exon 45, Homozygous

    1. Case#: 06012, Age 10, Male, Blood Type O+ (Table S3)

      Disease Assertion: VWD1

      FamilyInfo: Patient is member of Family# 0609, which includes 3 individuals. All members of the family have the same variant.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding score 10, VWF:Ag: 13, VWF:RCo:14, FVIII:C:40, VWF:CB:13

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.3363G>T (p.Arg1121Ser)

      ClinVar: N/A

      CAID: CA383511875 CAID

      gnomAD: N/A

    2. Case#: 02064, Age 32, Male, Blood type O- (Table S3)

      Disease Assertion: VWD 1

      FamilyInfo: Patient is a part of family # 0224. There are 3 other members of the family (02065, 02066, 02067). All members of the family have the same variant.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding score 13, VWF:Ag: 4.7, VWF:RCo: 5, FVIII:C: 16, VWF:CB:6

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations

      Gene:VWF

      Variant: NM_000552.4:c.3614G>A (p.Arg1205His)

      ClinVar: 308

      ClinVar

      CAID: CA114160

      CAID1

      gnomAD: N/A

    3. Case#: 27024, Age 56, Female, Blood Type A+ (Table S3)

      Disease Assertion: VWD 1

      FamilyInfo: The patient is the only member of Family#2713.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: VWF:Ag:5.3, VWF:RCo:6, FVIII:C:38, VWF:CB:4.2

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Bleeding Score 3

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.3467C>T (p.Thr1156Met) and c.-3151T>G

      ClinVar: 100264 ClinVar

      CAID: CA228414 CAID

      gnomAD: N/A

    4. Case#: 06024, Age 36, Female, Blood Type O+ (Table S3)

      Disease Assertion: VWD1

      FamilyInfo: The patient is the only member of Family#0617.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding Score 1, VWF:Ag:35, VWF:RCo:25, FVIII:C:69, VWF:CB: 27

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression:N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations

      Gene: VWF

      Variant: NM_000552.4:c.7300C>T (p.Arg2434Ter)

      ClinVar: 100464 ClinVar

      CAID: CA228781 CAID

      gnomAD: MAF of 0.0001298 (2/15414 alleles) in the European (non-Finnish) population. gnomAD

    5. Case#: 02058, Age 64, Female, Blood type A+ (Table S3)

      Disease Assertion: VWD1

      FamilyInfo: Patient is the only member of family #0221.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding score 19, VWF:Ag: 7.3, VWF:RCo: 5.9, FVIII:C: 19, VWF:CB: 6.3

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.3614G>A (p.Arg1205His)

      ClinVar: 308 ClinVar

      CAID: CA114160 CAID

      gnomAD: N/A

    6. Case#: 03035, Age 51, Male (Table S3)

      Disease Assertion: VWD1

      FamilyInfo: A part of family #03150 along with two other patients.

      Parental Genotype: Not listed

      CasePresentingHPOs: Not listed

      CaseHPOFreeText: Bleeding Score 4, VWF:Ag: 34, VWF:RCo: 26, FVIII:C: 43, VWF:CB 33

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression:N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations

      Gene: VWF

      Variant: NM_000552.4:c.3467C>T (p.Thr1156Met) and NM_000552.3:c.-3151T>G

      ClinVar: 100264 ClinVar

      CAID: CA228414 CAID

      gnomAD: N/A

    7. Case#: 32002, Age 49, Female, Blood Type +

      Disease Assertion: VWD 1

      FamilyInfo: The patient is the only member of Family# 3202.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: VWF:Ag: 34, VWF:RCo: 30, FVIII:C: 53, VWF:CB: 29

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Bleeding Score 3

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.7408C>T (p.Gln2470Ter)

      ClinVar: 100469 ClinVar

      CAID: CA228790 CAID

      gnomAD: MAF of 0.00002891 (1/34590 alleles) in the Latino population.

    8. Case#: 06007, Age 54, Male, Blood Type O+ (Table S3)

      Disease Assertion: VWD

      FamilyInfo: Two total patients were documented from family# 0606.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: VWF:Ag: 28, VWF:RCo: 26.1, FVIII:C: 56, VWF:CB: 23

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: Bleeding Score 5

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations

      Gene: VWF

      Variant: NM_000552.4:c.1156+2T>C (intronic)

      ClinVar: N/A

      CAID: CA383504978 CAID

      gnomAD: N/A

    9. Case#: 18001, Age 50, Male, Blood Type B+ (Table S3)

      Disease Assertion: VWD 1

      FamilyInfo: The patient one of 3 members of Family#1801. All of the patients have the same variant.

      Parental Genotype: N/A

      CasePresentingHPOs: N/A

      CaseHPOFreeText: VWF:Ag:10, VWF:RCo:6.1, FVIII:C:17, VWF:CB:8.2

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations

      Gene: VWF

      Variant: NM_000552.4:c.3614G>A (p.Arg1205His) and NM_000552.4:c.6989T>G (p.Val2330Gly)

      ClinVar: 308 ClinVar1

      CAID: CA114160 and CA6401808 CAID1 CAID2

      gnomAD: MAF of 0.000008823 (1/113342 alleles) in the European (non-Finnish population) (CA6401808) gnomAD

    10. Case#: 36008, Age 34, Female, Blood Type O+ (Table S3)

      Disease Assertion: VWD 1

      FamilyInfo: The patient is the only member of Family#3606.

      Parental Genotype: Not listed

      CasePresentingHPOs: N/A

      CaseHPOFreeText: Bleeding Score 8, VWF:Ag: 34, VWF:RCo:14, FVIII:C: 37, VWF:CB: 25

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.2771G>A(p.Arg924Gln) and NM_000552.4:c.3390C>T (p.Cys1130=)

      ClinVar: 627186 ClinVar

      CAID: CA228368 and CA478101454 CAID1 CAID2

      gnomAD: MAF of 0.01866 (2411/ 129182 alleles) in the European (non-Finnish) population (CA228368). gnomAD

    11. Case#: 02052, Age 25, Male, Blood type A+ (Table S3)

      Disease Assertion: VWD 1

      FamilyInfo: Patient is the only family member of family # 0220

      Parental Genotype: Not listed

      CasePresentingHPOs:N/A

      CaseHPOFreeText: Bleeding Score: 11, VWF:Ag: 15, VWF:RCO:12, FVIII:C:20, VWF:CB: 16

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      Protein Expression: N/A

      CasePreviousTesting: 48,48 Access-Array amplification. NGS Molecular analysis was performed. Sanger sequencing was used to validate selected mutations.

      Gene: VWF

      Variant: NM_000552.4:c.1625C>G (p.Ala542Gly) and NM_000552.4:c.6187C>T (p.Pro2063Ser)

      ClinVar: 381621 and 100436 ClinVar1

      ClinVar2

      CAID: CA6403319 and CA202650 CAID1

      CAID2

      gnomAD: MAF of 0.001355 (48/ 35418 alleles) in the Latino population (CA6403319). MAF of 0.04854 (1486/ 30616 alleles) in the South Asian Population (CA202650).

      gnomAD1

      gnomAD2

    1. The 26-year-old female IP is diagnosed to have type 3 VWD, due to no detectable VWF in plasma (VWF antigen (VWF:Ag) level < 4%).

      Case: Index Patient (IP), Female, 26 years old; described as from a genetically isolated population (not further specified), consistent with elevated homozygosity rates in that population. DiseaseAssertion: Type 3 VWD, confirmed by VWF:Ag <4 IU/dL (virtual absence of VWF). FamilyInfo: NA — no relatives' bleeding history or genotype reported ParentalGenotype(s): NA (not tested/not reported) CasePresentingHPOs: HP:0000421 (Epistaxis — frequent nosebleeds), HP:0000132 (Menorrhagia — heavy, prolonged, led to iron-deficiency anemia), HP:0001934 (Persistent bleeding after trauma — bleeding following injury), HP:0012147 (Reduced quantity of VWF; VWF:Ag <4 IU/dL), HP:0030129 (Impaired VWF:RCo-type activity; VWF:GPIbM <4 IU/dL) CaseHPOFreeText: Easy bruising (no matching HPO code in the approved list); FVIII:C 2.0 IU/dL (nv 70–157); referred to Hemophilia Centre at age 1 for bleeding complications; declined recommended lifelong prophylaxis due to injection discomfort, later underwent prophylaxis with plasma-derived VWF/FVIII concentrates and on-demand treatment (tranexamic acid, oral contraceptives, replacement therapy). Supporting functional evidence from patient-derived endothelial colony-forming cells (ECFCs): virtual absence of VWF mRNA (RQ ~0.04–0.05 vs. 1.00 in healthy controls, across 4 primer/probe sets); VWF secretion into ECFC medium 6.2% ± 0.4% of healthy controls (p<0.0001); near-total absence of Weibel-Palade bodies on immunofluorescence (only 1–3 small WPBs seen in some cells vs. normal stick-shaped WPBs in controls); altered intracellular trafficking of angiopoietin-2 (WPB inflammatory cargo) in the absence of WPBs. CaseNOTHPOs: NA CaseNOTHPOFreeText: NA CasePreviousTesting: Routine testing (Sanger sequencing of coding exons, ~50 bp flanking intronic regions, promoter, 5'/3'-UTR, plus MLPA) was negative — patient was "mutation-negative" prior to this study. Not genome-wide; targeted to VWF only, but comprehensive: this study's NGS covered the entire 176 kb VWF locus (all 52 exons, full intronic regions, promoter) at 30x coverage, going well beyond standard exon+flanking-intron approaches specifically to find deep intronic variants. GenotypingMethod: Illumina NovaSeq 6000 NGS (2×150 bp reads) of the whole VWF genomic region; variant annotation via Ensembl VEP with SpliceAI, PolyPhen-2, SIFT; splice effect independently confirmed with Neural Network Splicing, ASSP, and MaxEnt/HSF prediction tools. Functional validation via patient-derived ECFCs: RT-qPCR of VWF mRNA (4 primer/probe sets), cDNA sequencing, VWF:Ag ELISA of ECFC secretion, immunofluorescence microscopy, and whole-transcriptome RNA-seq. PreviouslyPublished: NA — no indication this patient was reported elsewhere; paper explicitly frames this variant/mechanism as a first report. Gene: VWF Variant: Novel homozygous deep intronic variant, intron 8, creating a new donor splice site that outcompetes the native donor site, causing inclusion of a 118-bp pseudoexon, frameshift, premature stop codon, and nonsense-mediated decay of the transcript. HGVS: NM_000552.5:c.997+118T>G (confirmed via ClinGen Allele Registry Community Standard Title; not explicitly stated in the paper's main text, which only gives cDNA/genomic coordinates without a transcript version). Genomic: g.6073501A>C (GRCh38/hg38; note the T>G/A>C discrepancy reflects VWF being transcribed from the minus strand of chr12). ClinVarID: NA CAID: CA3275979827 gnomAD: NA

    1. Val1316Met

      Gene:VWF

      HGNCID:12726

      Case:Preterm female newborn delivered by C/S

      DiseaseAssertion:VWD Type 2B

      FamilyInfo:Fig. 1 Father with VWD 2B and two paternal half-brothers diagnosed with hematomas after birth

      ParentalGenotype(s):heterozygous carrier p.(Val1316Met) confirmed in the father, half-brothers were not tested

      CasePresentingHPOs: HP:0001873, HP:0012147

      CaseHPOFreeRext:Multiple hematomas, no cerebral hemorrhage

      CaseNOTHPOs:HP:0030130

      CaseNOTHPOFreeText:analyses showed reduced VWF activity levels (40% at postnatal day 7), whereas VWF antigen was normal (146% at postnatal day 7)

      CasePreviousTesting:No . Gene:VWF

      Variant:p.Val1316Met

      HGVS:NM_000552.4:c.3946G>A

      ClinVarID:290

      CAID:CA114127

      gnomAD:6.20e-7

    1. P8

      Case: P8, M/32

      DiseaseAssertion: VWD1

      FamilyInfo: Positive family history, no details provided.

      ParentalGenotype: NA

      CaseHPOFreeText: The bleeding score was 7, aPTT was 39 seconds, FVIII:C was 10%, VWF:RCo was 14 IU/dL, and VWF:Ag was 13 IU/dL, resulting in a VWF:RCo/VWF:Ag ratio of 1.1. The VWF multimer pattern showed a mild loss of high molecular weight multimers, RIPA was not tested, and the platelet count was 286 × 10⁹/L.

      CasePreviousTesting: NA

      GenotypingMethod: Direct sequencing of all exons, flanking intronic sequences, and the promoter of VWF was performed.

      Gene: VWF

      Variant: c.2665T>C, p.C889R — heterozygous

      HGVS: NM_000552.5(VWF):c.2665T>C (p.Cys889Arg)

      ClinVar:

      CAID: CA383519992

      gnomAD: absent from gnomad v4.1.0

    2. P6

      Case: P6, F/7

      DiseaseAssertion: VWD1

      FamilyInfo: No family history

      ParentalGenotype: NA

      CaseHPOFreeText: The bleeding score was 5, aPTT was 29 seconds, FVIII:C was 71%, VWF:RCo was 19 IU/dL, and VWF:Ag was 19 IU/dL, with a VWF:RCo/VWF:Ag ratio of 1.0. The VWF multimer pattern was normal, RIPA was not tested, and the platelet count was 475 × 10⁹/L.

      CasePreviousTesting: NA

      GenotypingMethod: Direct sequencing of all exons, flanking intronic sequences, and the promoter of VWF was performed.

      Gene: VWF

      Variant: no mutation detected

      HGVS:

      ClinVar:

      CAID:

      gnomAD:

    3. P10

      Case: P10, M/2

      DiseaseAssertion: VWD1

      FamilyInfo: No family history

      ParentalGenotype: NA

      CaseHPOFreeText: The bleeding score was 1, aPTT was 33 seconds, FVIII:C was 96%, VWF:RCo was 30 IU/dL, and VWF:Ag was 36 IU/dL, resulting in a VWF:RCo/VWF:Ag ratio of 0.8. The VWF multimer pattern was normal, RIPA was not tested, and the platelet count was 222 × 10⁹/L.

      CasePreviousTesting: NA

      GenotypingMethod: Direct sequencing of all exons, flanking intronic sequences, and the promoter of VWF was performed.

      Gene: VWF

      Variant: c.3835G>A, p.V1279I — heterozygous

      HGVS: NM_000552.5(VWF):c.3835G>A (p.Val1279Ile)

      ClinVar: 100288

      CAID: CA228459

      gnomAD: https://gnomad.broadinstitute.org/variant/chr12-6019583-C-T?dataset=gnomad_r4

    1. 3*ItalyF/21<1—NoSevere666G→A/823T→AW222X/C275S7/7HeterozygousN.A./BsrI (+)

      Case: 3, F, 21, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): <1, Bleeding symptoms: Severe

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      666G→A (Trp222X), Exon 7

      823T→A (Cys275Ser), Exon 7

      Compound Heterozygous

    2. 2ItalyF/58<1—NoSevere421G→T/2016del4D141Y/FS5/16HeterozygousBstYI (+)/N.A.

      Case: 2, F, 58, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): <1, Bleeding symptoms: Severe

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      421G→T (Asp141Tyr), Exon 5

      2016del4 (FS), Exon 16

      Compound Heterozygous

    3. 8*ItalyF/7<1—NoMild4013C→G/6385G→TS1338X/E2129X28/37HeterozygousN.A./MnlI (−)

      Case: 8, F, 7, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): <1, Bleeding symptoms: Mild

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      4013C→G (Ser1338X), Exon 28

      6385G→T (Glu2129X), Exon 37

      Compound Heterozygous

    4. 4ItalyM/55<1—NoSevere1093C→T/1830C→AR365X/Y610X9/15HeterozygousTaqI (−)/DdeI (+)

      Case: 4 , M, 55, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): <1, Bleeding symptoms: Severe

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      1093C→T (Arg365X), Exon 9

      1830C→A (Tyr610X), Exon 15

      Compound Heterozygous

    5. 30*IndiaF/321—NoMild6977-1G→CFS41HomozygousDraIII (+)

      Case: 30, F, 32, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: No

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): 1, Bleeding symptoms: Mild

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      6977-1G→C (intronic), Exon 41, Homozygous

      Note: The article assumes 6977-1G→C would be a frameshift mutation. It is possible that the homozygous zygosity was detected from a PCR artifact (e.g. presence of a large gene deletion or point mutation that prevents amplification); different sets of primers were used, providing conformation and excluding the possibility for a PCR artifact due to point mutation. No potential splice site mutation was confirmed at the mRNA level; “Splice Site Prediction program” found all mutations likely to disrupt normal splicing. No possible splice site mutation could be identified on 100 chromosomes from a group of 50 normal subjects with same genetic background as patients, excluding the possibility that these mutations represent common polymorphisms

    6. 18*IranM/212—YesSevere1930G→TE644X15HomozygousHaeII (+)

      Case: 18, M, 21, Iranian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: Yes

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): 2, Bleeding symptoms: Severe

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      1930G→T (Glu644X), Exon 15, Homozygous

    7. 37IndiaF/29<1—NoMild1896G→A/3212G→TW642X/C1071F15/24HeterozygousMaeIII (+)/N.A.

      Case: 37, F, 29, Indian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: No

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (U/dl): <1, Bleeding symptoms: Mild

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      1896G→A (Trp642X), Exon 15

      3212G→T (Cys1071Phe), Exon 24

      Compound Heterozygous

    1. 1

      Case: 2B-8

      DiseaseAssertion: VWD2B

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: AcuStar RCo/Ag = 0.99; AcuStar CB/Ag = 1.35; ELISA CB/Ag = 1.02

      CaseHPOFreeText:

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: not described

      PreviouslyPublished: 16985174

      Gene: VWF

      Variant: c.3797C>T (p.Pro1266Leu)

      HGVS: NM_000552.5(VWF):c.3797C>T (p.Pro1266Leu)

      ClinVarID: 314; https://www.ncbi.nlm.nih.gov/clinvar/variation/314/?new_evidence=false

      CAID:

      gnomAD: MAF (European, Finnish) = 0.003667; 1 homozygote; https://gnomad.broadinstitute.org/variant/12-6128787-G-A

    2. 1

      Case: 2A-7

      DiseaseAssertion: VWD2A

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: AcuStar RCo/Ag = 0.27; AcuStar CB/Ag = 0.10; ELISA CB/Ag = 0.39

      CaseHPOFreeText:

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: not described

      PreviouslyPublished: PMID:1673047

      Gene: VWF

      Variant: c.4883T>C (p.Ile1628Thr)

      HGVS: NM_000552.5(VWF):c.4883T>C (p.Ile1628Thr)

      ClinVarID: 284; https://www.ncbi.nlm.nih.gov/clinvar/variation/284/?new_evidence=false

      CAID:

      gnomAD: absent

    3. 0.49

      Case: 2A-1

      DiseaseAssertion: VWD2A

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: AcuStar RCo/Ag = 0.49; AcuStar CB/Ag = 0.29; ELISA CB/Ag = 0.33

      CaseHPOFreeText:

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: not described

      PreviouslyPublished: PMID: 8435341

      Gene: VWF

      Variant: c.4541T>G (p.Phe1514Cys)

      HGVS: NM_000552.5(VWF):c.4541T>G (p.Phe1514Cys)

      ClinVarID: 304; https://www.ncbi.nlm.nih.gov/clinvar/variation/304/?new_evidence=false

      CAID:

      gnomAD: absent

    1. rs2676073266132007c.3437A > G26p.Y1146C1042A

      Case: n.a.

      DiseaseAssertion: VWD 2A

      FamilyInfo: n.a.

      ParentalGenotype(s):n.a.

      CasePresentingHPOs:n.a.

      CaseHPOFreeRext:n.a.

      CaseNOTHPOs:n.a.

      CaseNOTHPOFreeText:n.a.

      CasePreviousTesting:n.a.

      GenotypingMethod:n.a.

      PreviouslyPublished: If applicable.n.a.

      Gene:VWF

      Variant:NM_000552.5(VWF):c.3437A>G (p.Tyr1146Cys)

      HGVS:NM_000552.5:c.3437A>G

      ClinVarID:31009

      CAID:n.a.

      gnomAD:n.a.

    1. Case: P10, Chinese, male, 5yo

      DiseaseAssertion: VWD1

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type A blood, bleeding score = 2; VWF:Ag (%) = 4.2, VWF:RCo (%) = 3.8, FVIII:C (%) = 30.1, VWF:CB (%) = 3.5, VWFpp (%) = 4.1, VWF:RCo/VWF:Ag = 0.9, VWF:CB/VWF:Ag = 0.8, VWFpp/VWF:Ag = 1.0, FVIII:C/VWF:Ag = 7.4, RIPA (1.2 mg/ml, %) = 40.1

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant 1: c.7199delA (p.Asn2400Thrfs*4) - Unregistered Variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

      Variant 2: c.8155+5G>C - Unregistered Variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    2. Case: P6, Chinese, male, 57yo

      DiseaseAssertion: VWD2A

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type AB blood, bleeding score = 15; VWF:Ag (%) = 18.5, VWF:RCo (%) = 5.8, FVIII:C (%) = 39.0, VWF:CB (%) = 4.9, VWFpp (%) = 36.4, VWF:RCo/VWF:Ag = 0.3, VWF:CB/VWF:Ag = 0.3, VWFpp/VWF:Ag = 2.0, FVIII:C/VWF:Ag = 2.1

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.3920T>G (p.Leu1307Arg)

      HGVS: NM_000552.5:c.3920T>G (p.Leu1307Arg)

      ClinVarID: NA

      CAID: CA383506205; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA383506205

      gnomAD: absent

    3. Case: P72, Chinese, female, 25yo

      DiseaseAssertion: VWD2B

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type A blood, bleeding score = 7; VWF:Ag (%) = 31.1, VWF:RCo (%) = 10.5, FVIII:C (%) = 44.8, VWF:CB (%) = 5.4, VWFpp (%) = 73, VWF:RCo/VWF:Ag = 0.3, VWF:CB/VWF:Ag = 0.2, VWFpp/VWF:Ag = 2.3, FVIII:C/VWF:Ag = 1.4, RIPA (0.5 mg/ml, %) = 8.7, PLT(×109/l) = 181

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.3939G>C (p.Trp1313Cys)

      HGVS: NM_000552.4(VWF):c.3939G>C (p.Trp1313Cys)

      ClinVarID: 287; https://www.ncbi.nlm.nih.gov/clinvar/variation/287/

      CAID: NA

      gnomAD: absent

    4. Case: P77, Chinese, female, 10yo

      DiseaseAssertion: VWD3

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type B blood, bleeding score = 7; VWF:Ag (%) = 3.0, VWF:RCo (%) = 2.7, FVIII:C (%) = 6.8, VWF:CB (%) = 2.1, VWFpp (%) = 3.2, VWF:RCo/VWF:Ag = 0.9, VWF:CB/VWF:Ag = 0.7, VWFpp/VWF:Ag = 1.1, FVIII:C/VWF:Ag = 2.3

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant 1: c.6771C>A (p.Cys2257Ter)

      HGVS: NM_000552.5:c.6771C>A (p.Cys2257Ter)

      ClinVarID: NA

      CAID: CA383489897; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA383489897

      gnomAD: absent

      Variant 2: c.8116-2delA - unregistered variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    5. Case: P34, Chinese, female, 34yo

      DiseaseAssertion: VWD2B

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type O blood, bleeding score = 13; VWF:Ag (%) = 20.2, VWF:RCo (%) = 6.9, FVIII:C (%) = 32.9, VWF:CB (%) = 4.8, VWFpp (%) = 54.5, VWF:RCo/VWF:Ag = 0.3, VWF:CB/VWF:Ag = 0.2, VWFpp/VWF:Ag = 2.7, FVIII:C/VWF:Ag = 1.6, RIPA (0.5 mg/ml, %) = 65.1, PLT(×109/l) = 153

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.3916C>T (p.Arg1306Trp)

      HGVS: NM_000552.4(VWF):c.3916C>T (p.Arg1306Trp)

      ClinVarID: 288; https://www.ncbi.nlm.nih.gov/clinvar/variation/288/

      CAID: NA

      gnomAD: absent

    6. Case: P61, Chinese, female, 34yo

      DiseaseAssertion: VWD1

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type O blood, bleeding score = 2; VWF:Ag (%) = 57.6, VWF:RCo (%) = 57.8, FVIII:C (%) = 76.2, VWF:CB (%) = 67.4, VWFpp (%) = 62.7, VWF:RCo/VWF:Ag = 1.0, VWF:CB/VWF:Ag = 1.2, VWFpp/VWF:Ag = 1.1, FVIII:C/VWF:Ag = 1.3

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.-128G>A

      HGVS: NM_000552.3:c.-128G>A

      ClinVarID: NA

      CAID: CA603092904; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA603092904

      gnomAD: MAF = 0.001182 (1/846 alleles) in Latino/Admixed American population; https://gnomad.broadinstitute.org/variant/12-6233714-C-T

    7. Case: P27, Chinese, female, 3yo

      DiseaseAssertion: VWD2N

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type B blood, bleeding score = 6; VWF:Ag (%) = 9.5, VWF:RCo (%) = 8.9, FVIII:C (%) = 6.5, VWF:CB (%) = 6.9, VWFpp (%) = 10.8, VWF:RCo/VWF:Ag = 0.9, VWF:CB/VWF:Ag = 0.7, VWFpp/VWF:Ag = 1.1, FVIII:C/VWF:Ag = 0.7, VWF: FVIIIB (%) = 0.0

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant 1: c.2396G>A (p.Cys799Tyr)

      HGVS: NM_000552.5:c.2396G>A (p.Cys799Tyr)

      ClinVarID: NA

      CAID: CA232300402; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA232300402

      gnomAD: absent

      Variant 2: c.3197_3201del - unregistered variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    8. Case: P36, Chinese, male, 56yo

      DiseaseAssertion: VWD3

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type A blood, bleeding score = 10; VWF:Ag (%) = 1.0, VWF:RCo (%) = 0.9, FVIII:C (%) = 4.1, VWF:CB (%) = 0.9, VWFpp (%) = 0.9, VWF:RCo/VWF:Ag = 0.9, VWF:CB/VWF:Ag = 0.9, VWFpp/VWF:Ag = 0.9, FVIII:C/VWF:Ag = 4.1

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.5870delA - unregistered variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    9. Case: P83, Chinese, male, 5yo

      DiseaseAssertion: VWD1

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: patient coexisting with mild haemophilia A; type O blood, bleeding score = 3; VWF:Ag (%) = 44.5, VWF:RCo (%) = 36.7, FVIII:C (%) = 12.6, VWF:CB (%) = 49.2, VWFpp (%) = 35.2, VWF:RCo/VWF:Ag = 0.8, VWF:CB/VWF:Ag = 1.1, VWFpp/VWF:Ag = 0.8, FVIII:C/VWF:Ag = 0.3

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.6104G>A (p.Gly2035Asp)

      HGVS: NM_000552.3:c.6104G>A (p.Gly2035Asp)

      ClinVarID: NA

      CAID: CA6402069; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA6402069

      gnomAD: MAF = 0.005613 (112/19954 alleles; 2 homozygotes) in the East Asian population; https://gnomad.broadinstitute.org/variant/12-6103733-C-T

      Multiple Gene Variants

      Gene: F8

      Variant: c.943G>T (p.Ala315Ser)

      HGVS: NM_000132.3:c.943G>T (p.Ala315Ser)

      ClinVarID: NA

      CAID: CA414917823; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA414917823

      gnomAD: absent

    10. Case: P29, Chinese, male, 10yo

      DiseaseAssertion: VWD2M

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type B blood, bleeding score = 5; VWF:Ag (%) = 13.9, VWF:RCo (%) = 5.9, FVIII:C (%) = 37.8, VWF:CB (%) = 17.4, VWFpp (%) = 31.3, VWF:RCo/VWF:Ag = 0.4, VWF:CB/VWF:Ag = 1.3, VWFpp/VWF:Ag = 2.3, FVIII:C/VWF:Ag = 2.7

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.3943C>T (p.Arg1315Cys)

      HGVS: NM_000552.4(VWF):c.3943C>T (p.Arg1315Cys)

      ClinVarID: 100310; https://www.ncbi.nlm.nih.gov/clinvar/variation/100310/

      CAID: NA

      gnomAD: absent

    11. Case: P22, Chinese, male, 22yo

      DiseaseAssertion: VWD3

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type O blood, bleeding score = 10; VWF:Ag (%) = 1.4, VWF:RCo (%) = 1.2, FVIII:C (%) = 5.1, VWF:CB (%) = 1.3, VWFpp (%) = 1.0, VWF:RCo/VWF:Ag = 0.9, VWF:CB/VWF:Ag = 0.9, VWFpp/VWF:Ag = 0.7, FVIII:C/VWF:Ag = 3.6

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.8116–2delA - Unregistered variant

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    12. Case: P42, Chinese, male, 10yo

      DiseaseAssertion: VWD1

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type O blood, bleeding score = 1; VWF:Ag (%) = 41.9, VWF:RCo (%) = 33.9, FVIII:C (%) = 54.7, VWF:CB (%) = 46.8, VWFpp (%) = 34.6, VWF:RCo/VWF:Ag = 1.0, VWF:CB/VWF:Ag = 1.1, VWFpp/VWF:Ag = 0.8, FVIII:C/VWF:Ag = 1.3

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.-672C>T

      HGVS: NA

      ClinVarID: NA

      CAID: NA

      gnomAD: NA

    13. Case: P33, Chinese, female, 35yo

      DiseaseAssertion: VWD3

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs: HP:0012147

      (Reduced quantity of VWF)

      CaseHPOFreeText: type A blood, bleeding score = 10; VWF:Ag (%) = 0.5, VWF:RCo (%) = <0.5, FVIII:C (%) = 5.0, VWF:CB (%) = <0.5, VWFpp (%) = <0.5, VWF:RCo/VWF:Ag = NA, VWF:CB/VWF:Ag = NA, VWFpp/VWF:Ag = NA, FVIII:C/VWF:Ag = 10.0

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting: NA

      GenotypingMethod: NGS

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.813C>G (p.Tyr271Ter)

      HGVS: NM_000552.5:c.813C>G (p.Tyr271Ter)

      ClinVarID: NA

      CAID: CA383508522; http://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA383508522

      gnomAD: MAF = 0.0001088 (2/18380 alleles) in the East Asian popualtion; https://gnomad.broadinstitute.org/variant/12-6184562-G-C

    1. II : 1

      Case#: F20, II:1

      DiseaseAssertion: Type 2 VWD

      CaseHPOFreeText: loss of high and intermediate MWMs, VWF:Ag = 45; VWF:RCo = 7; VWF:GPIbM = 43; 0.16; 0.95; 6.11

      CasePreviousTesting: Not clearly described

      Gene: VWF

      Variant: p.[V1316M];[=]

      HGVS: c.3946G>A (p.Val1316Met)

      CAID: CA114127

      gnomAD: absent from gnomad v4.1.0

    2. I : 1

      Case#: F8, I:1

      DiseaseAssertion: Type 2 VWD

      CaseHPOFreeText: partial loss of high molecular weight multimers, VWF:Ag = 37; VWF:RCo = 21; VWF:GPIbM = 34; 0.57; 0.92; 1.60

      CasePreviousTesting: Not clearly described

      Gene: VWF

      Variant: p.[P1337L];[=]

      HGVS: c.4010C>T (p.Pro1337Leu)

      CAID: CA228510

      gnomAD: https://gnomad.broadinstitute.org/variant/12-6019408-G-A?dataset=gnomad_r4

    1. Molecular basis of von Willebrand disease type IIB. Candidate mutations cluster in one disulfide loop between proposed platelet glycoprotein Ib binding sequences.

      PMID: 2010538

      Gene: VWF

      HGNC: 12726

      Disease: von Willebrand disease type 2B

      MONDO: 0015629

      InheritancePattern: Autosomal Dominant

      Prevalence: Overall VWD prevalence is estimated to be as high as 1 in 100 in the general population, with 1 in 10,000 pursuing tertiary care referral ((PMID: 28847738).

      Penetrance: Fully penetrant / nearly fully penetrant for most pathogenic type 2 variants

    1. Impact of mutations in the von Willebrand factor A2 domain on ADAMTS13-dependent proteolysis

      PMID 16322474

      Notes Recombinant full length p.Ile1628Thr expressed in HEK293 and purified from growth media was NOT digested by recombinant ADAMTS13 in non-denaturing conditions (Table 1, Fig 5a). However, the the A1-A3 p.Ile1628Thr truncations were digested by ADAMTS13 in non-denaturing conditions while WT recombinant VWF truncations were not (Fig 6).

    1. T090M/280.010.040.01c.1117C>T, gene conversion (c.3931C>T, c.4027A>G, c.4079T>C, c.4105T>A)p.Arg373*, p.Gln1311*, p.Ile1343Val, p.Val1360Ala, p.Phe1369Ile10/28Compound heterozygous

      Case: T090, M, 2

      DiseaseAssertion: VWD type 3

      FamilyInfo: inherited heterozygous gene conversion from the father

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Bleeding Score: 8 (Kruskal–Wallis followed by Mann–Whitney U post-hoc testing Post-hoc testing ), VWF:Ag (IU/ml): 0.01, VWF:RCo (IU/ml): 0.04, FVIII:C (IU/ml): 0.01

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.1117C>T (p.Arg373*)

      Gene Conversion (

      c.3931C>T (p.Gln1311*)

      c.4027A>G (p.Ile1343Val)

      c.4079T>C (p.Val1360Ala)

      c.4105T>A (p.Phe1369Ile)

      )

      Exon 10/28

      Compound heterozygous

      Note: ELISA-based assay for detecting alloantibodies, genomic analysis via sequencing of leukocytes for the VWF gene including exons 1-52 and about 1.5 km of VWF promoter, PCR amplification for variant confirmation, SALSA-MLPAVWF assay evaluation for partial/total gene deletions when sequencing did not reveal pathogenic explanation

    2. T078F/590.010.030.01c.5455 + 2 T>C-31Homozygous

      Case: T078, F, 5

      DiseaseAssertion: VWD type 3

      FamilyInfo: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Bleeding Score: 9 (Kruskal–Wallis followed by Mann–Whitney U post-hoc testing Post-hoc testing ), VWF:Ag (IU/ml): 0.01, VWF:RCo (IU/ml): 0.03, FVIII:C (IU/ml): 0.01

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.5455 + 2 T>C, Exon 31, Homozygous

      Note: ELISA-based assay for detecting alloantibodies, genomic analysis via sequencing of leukocytes for the VWF gene including exons 1-52 and about 1.5 km of VWF promoter, PCR amplification for variant confirmation, SALSA-MLPAVWF assay evaluation for partial/total gene deletions when sequencing did not reveal pathogenic explanation

    3. T028M/34160.010.010.03c.7730-1 G>T, c.7906A>T-, p.Asn7906Tyr46/48HomozygousHeterozygous

      Case: T028, M, 34

      DiseaseAssertion: VWD type 3

      FamilyInfo: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: Bleeding Score: 16 (Kruskal–Wallis followed by Mann–Whitney U post-hoc testing Post-hoc testing ), VWF:Ag (IU/ml): 0.01, VWF:RCo (IU/ml): 0.01, FVIII:C (IU/ml): 0.03

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: n/a

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.7730-1 G>T, Exon 46, Homozygous

      c.7906A>T (p.Asn7906Tyr), Exon 48, Heterozygous

      Note: ELISA-based assay for detecting alloantibodies, genomic analysis via sequecning of leukocytes for the VWF gene including exons 1-52 and about 1.5 km of VWF promoter, PCR amplification for variant confirmation, SALSA-MLPAVWF assay evaluation for partial/total gene deletions when sequencing did not reveal pathogenic explanation

    1. 8 Type 2A /2N c.2561G > Ac.4811T > A Np.Arg854Glnp.Val1604Asp2028D’-E’A2htzhtzMissenseMissenseA 16 8 12

      Case: 8 (also in row 21 table 6)

      DiseaseAssertion: type 2A/2N VWD

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: HP:0032370 - blood group A

      CaseHPOFreeRext: VWF:Ag [IU/dL] = 16; VWF:Ac [IU/dL] = 8; FVIII:C [IU/dL] = 12

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: Sequence variations in the VWF were identified through direct sequencing, while the detection of large rearrangements utilized the multiplex ligation-dependent probe amplification (MLPA) technique or assessed copy number variations (CNVs). Sanger sequencing methodology was applied for VWF analysis in patients investigated prior to 2016 (approximately 14% of IPs), whereas next-generation sequencing (NGS) was employed for the analysis of VWF in patients inspected from 2017 onwards (about 86% of IPs). In both strategies, the entire VWF, encompassing all 52 exons, intron/exon boundaries, and promoter regions, was analyzed.

      PreviouslyPublished:

      Gene: VWF

      Variant: c.2561G>A p.Arg854Gln

      HGVS:

      ClinVarID: 296

      CAID:

      gnomAD: 0.004956 (8000 in 1614214) 26 homozygotes https://gnomad.broadinstitute.org/variant/12-6034812-C-T?dataset=gnomad_r4

      MultipleGeneVariants:

      Gene: VWF

      Variant: c.4811T>A p.Val1604Asp

      CAID: CA383499144

      gnomAD: absent

    2. 42 U c.7645T > C N p.Cys2549Arg 45 C4 htz Missense O 9 16 41

      Case: IP #42 in type U VWD sub-cohort (also in row 26 table 6)

      DiseaseAssertion: unclassified VWD

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: HP:0032442 - blood group O

      CaseHPOFreeRext: VWF:Ag [IU/dL] = 9; VWF:Ac [IU/dL] = 16; FVIII:C [IU/dL] = 41

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: Sequence variations in the VWF were identified through direct sequencing, while the detection of large rearrangements utilized the multiplex ligation-dependent probe amplification (MLPA) technique or assessed copy number variations (CNVs). Sanger sequencing methodology was applied for VWF analysis in patients investigated prior to 2016 (approximately 14% of IPs), whereas next-generation sequencing (NGS) was employed for the analysis of VWF in patients inspected from 2017 onwards (about 86% of IPs). In both strategies, the entire VWF, encompassing all 52 exons, intron/exon boundaries, and promoter regions, was analyzed.

      PreviouslyPublished:

      Gene: VWF

      Variant: c.7645T>C p.Cys2549Arg

      HGVS:

      ClinVarID: not found

      CAID: CA383489376

      gnomAD: absent

    3. 2 c.3847G > A N p.Asp1283Asn 28 A1 htz Missense A 45 9 70 CSA 38

      Case: IP #2 in type 2M VWD sub-cohort (also in row 12 table 6)

      DiseaseAssertion: type 2M VWD

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs: HP:0032370 - blood group A

      CaseHPOFreeRext: VWF:Ag [IU/dL] = 45; VWF:Ac [IU/dL] = 9; FVIII:C [IU/dL] = 70; VWF:CB (IU/dL) = 38

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: Sequence variations in the VWF were identified through direct sequencing, while the detection of large rearrangements utilized the multiplex ligation-dependent probe amplification (MLPA) technique or assessed copy number variations (CNVs). Sanger sequencing methodology was applied for VWF analysis in patients investigated prior to 2016 (approximately 14% of IPs), whereas next-generation sequencing (NGS) was employed for the analysis of VWF in patients inspected from 2017 onwards (about 86% of IPs). In both strategies, the entire VWF, encompassing all 52 exons, intron/exon boundaries, and promoter regions, was analyzed.

      PreviouslyPublished:

      Gene: VWF

      Variant: c.3847G>A p.Asp1283Asn

      HGVS:

      ClinVarID: not found

      CAID: CA383506815

      gnomAD: absent

    1. 2B

      Case: 2B, male, 55yo

      DiseaseAssertion: VWD2B

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs:

      CaseHPOFreeText: Blood type: O+, bleeding score = 17, VWF:Ag (IU/mL) = 0.40; VWF:RCo (IU/mL) = 0.13; FVIII:C (IU/mL) = 0.46

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: qRT-PCR

      PreviouslyPublished:

      Gene: VWF

      Variant: c.3946G>A (p.Val1316Met)

      HGVS: NM_000552.5(VWF):c.3946G>A (p.Val1316Met)

      ClinVarID: 290; https://www.ncbi.nlm.nih.gov/clinvar/variation/290/?new_evidence=false

      CAID:

      gnomAD: absent

    2. 2M

      Case: 2M, female, 25yo

      DiseaseAssertion: VWD2M

      FamilyInfo:

      ParentalGenotype(s):

      CasePresentingHPOs:

      CaseHPOFreeText: Blood type: A+, bleeding score = 7, VWF:Ag (IU/mL) = 0.11; VWF:RCo (IU/mL) = 0.03; FVIII:C (IU/mL) = 0.39

      CaseNOTHPOs:

      CaseNOTHPOFreeText:

      CasePreviousTesting:

      GenotypingMethod: qRT-PCR

      PreviouslyPublished:

      Gene: VWF

      Variant: c.4145T>C (p.Leu1382Pro)

      HGVS: NM_000552.5:c.4145T>C (p.Leu1382Pro)

      ClinVarID: n/a

      CAID: CA383504407; https://reg.clinicalgenome.org/redmine/projects/registry/genboree_registry/by_caid?caid=CA383504407

      gnomAD: absent

    1. 2 M/40 <1 6 Yes 21 c.8155+1G>Ta p.G2706_C2719delfsX25a (50) Homozygous

      Case: 2, M, 40, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (IU/dL): <1, FVIII:C (IU/dL): 6, Bleeding Score: 21

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.8155+1G>T (p.Gly2706_Cys2719delfsX25), Intron 50, Homozygous

      Note: patient also has heterozygous insertion of five intronic nucleotides (GTAAG) between exons 45 and 46; c.8155+1G>T resulted in altering the normal mRNA splicing process

    2. 4 M/5 <1 17 NR 6 c.2269delCT p.L757VfsX22 17 Homozygous

      Case: 4, M, 5, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: not reported

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (IU/dL): <1, FVIII:C (IU/dL): 17, Bleeding Score: 6

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2269delCT (p.Leu757ValfsX22), Exon 17, Homozygous

      Note: paretns investigated for the probands defects and confirmed to carry the expected mutation at the heterozygous state

    3. 6 M/28 <1 9 No 15 c.2157delA/c.7729+7C>T p.D720TfsX21/p.E2577GfsX21 16/(45) Heterozygous

      Case: 6, M, 28, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: no

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (IU/dL): <1, FVIII:C (IU/dL): 9, Bleeding Score: 15

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2157delA (p.Asp20ThrfsX21), Exon 16

      c.7729+7C>T (p.Glu2577GlyfsX21), Intron 45

      Compound Heterozygous

      Note: patient also has homozygous deletion of 40 bp (NP_000543.2, where 1 is adenine in ATG initiation codon) due to the skipping of exon 50; c.7729+7C>T resulted in altering the normal mRNA splicing process

    4. 3 F/5 <1 4 Yes 9 c.658–2A>Ga p.G220_S292delfsX27a (6) Homozygous

      Case: 3, F, 5, Italian

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: yes

      ParentalGenotype: n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeText: VWF:Ag (IU/dL): <1, FVIII:C (IU/dL): 4, Bleeding Score: 9

      CaseNotHPOs: n/a

      CaseNotHPOFreeText: Anti-VWF alloantibodies: no

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.658–2A>G (p.Gly220_Ser292delfsX27), Intron 6, Homozygous

      Note: patient also has homozygous deletion of 217 bp (NP_000543.2, where 1 is adenine in ATG initiation codon) due to the skipping of exon 7; c.658–2A>G resulted in altering the normal mRNA splicing process

  2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov
    1. The patient investigated (proband

      Case-Individual:

      Case: 50-year old male of consanguinous parents

      DiseaseAssertion: severe Type 1 Von Willebrand Disease, previously misclassified as Type 3

      Family Info: Proband's parents and offspring had the same mutation, but at the heterozygous level; all asymptomatic

      Parental Genotype: N/A

      CasePresentingHPOs: HP:0000421, HP:0030140, HP:0006298, HP:0005261

      Epistaxis, oral cavity bleeding, severe hemorrhagic complications after tooth extractions (HP is called Prolonged bleeding after dental extraction), hemarthrosis (joint bleeding)

      CaseHPOFreeRext: Lifelong history of severe bleeding, frequent hematomas, bleeding from minor wounds (possibly HP:0030138, excessive bleeding from superficial cuts), impaired hemostatic picture, extremely high ISTH bleeding score (proband's was 30 whereas males usually range from 0-3)

      CaseNOTHPOs: N/A

      CaseNOTHPOFreeText: N/A

      CasePreviousTesting: N/A

      GenotypingMethod: Sequencing reactions were performed in an ABI3130 XL Genetic Analyzer; digital droplet polymerase chain reaction (ddPCR) assays were performed (in multiplex); in vitro expression also performed, then electrophoresis system used to run Western blot

      Gene: VWD

      HGVS: NM_000552.5:c.2269_2270del

      Variant: Gene null homozygous c.2269_2270del mutation

      ClinVarID: 100207

      CAID: CA228313

      gnomAD: MAF of 0.000002542 (3 of 1180022 alleles) in the European non-Finnish population

    1. 32 K

      Case: Patient 32, Family K (Table 1.), F/17, Afro-Caribbean

      DiseaseAssertion: VWD2A (IIE)

      FamilyInfo: Patient 18 (F/53, Afro-Carribean), Patient 29 (F/33, Afro-Caribbean), Patient 33 (F/49, Afro-Caribbean) also from Family K. (Table 1.)

      ParentalGenotype(s): NA

      CasePresentingHPOs:

      CaseHPOFreeRext: BAT =4, FVIII:C (IU/dL) = 79, VWF:Ag (IU/dL) = 49, VWF:Act (IU/dL) = 37

      CaseNOTHPOs:

      CaseNOTHPOFreeText: Blood type O+

      CasePreviousTesting:

      GenotypingMethod: All samples were analyzed by captured-based high throughput sequencing which was performed with a custom-design of the VWF gene provided by Twist BioScience (San Francisco, USA). It comprised all 52 exons, intronic flanking regions, promoter and 3’UTR region of the VWF gene. Libraries were prepared by using the Twist NGS target enrichment solution (Twist BioScience) according to the manufacturer protocol. Samples were analyzed on a NovaSeq 6000 sequencer (Illumina) with a median read depth of 2500X by using the 300-cycle S1 NovaSeq 6000seq reagent kit with 150-bp paired-end reads. The raw data were analyzed with Mutect21 and Vardict2 tools. The inhouse NGSreport software (CHU Lille) was used for data visualization, sequences check and conservation of variants with high quality metrics. In some cases, patients genomic DNA was screened for sequence variations (large deletions, insertions and duplications) by Multiplex Ligation-dependent Probe Amplification (MCR Holland).

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.2365A > G, p.(Thr789Ala)

      HGVS: NM_000552.5:c.2365A>G (p.Thr789Ala)

      ClinVarID: 256659

      CAID: CA6403090

      gnomAD: MAF of 0.5793 (43409/74928 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6044368-T-C?dataset=gnomad_r4

      Variant: c.2385T > C, p.(Tyr795 =)

      HGVS: NM_000552.5:c.2385T>C (p.Tyr795=)

      ClinVarID: 256660

      CAID: CA6403087

      gnomAD: MAF of 0.5788 (43385/74952 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6044348-A-G?dataset=gnomad_r4

      Variant: c.2880G > A, p.(Arg960 =)

      HGVS: NM_000552.5:c.2880G>A (p.Arg960=)

      ClinVarID: 195657

      CAID: CA201877

      gnomAD: MAF of 0.3169 (23737/74896 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6029429-C-T?dataset=gnomad_r4

      Variant: c.3505T > A, p.(Cys1169Ser)

      HGVS: NM_000552.5:c.3505T>A (p.Cys1169Ser)

      ClinVarID:

      CAID: CA383511219

      gnomAD:

    2. 39 S

      Case: Patient 39, Family S (Table 1.), F/76, Afro-Caribbean

      DiseaseAssertion: VWD2A (IIA)

      FamilyInfo: Patient 40 (F/38, Afro-Caribbean), Patient 41 (M/63, Afro-Caribbean) and Patient 52 (F/48, Afro Caribbean) also from Family S. (Table 1.)

      ParentalGenotype(s): NA

      CasePresentingHPOs:

      CaseHPOFreeRext: BAT = 3, FVIII:C (IU/dL) = 74, VWF:Ag (IU/dL) = 35, VWF:Act (IU/dL) = 12

      CaseNOTHPOs:

      CaseNOTHPOFreeText: Blood group O+

      CasePreviousTesting:

      GenotypingMethod: All samples were analyzed by captured-based high throughput sequencing which was performed with a custom-design of the VWF gene provided by Twist BioScience (San Francisco, USA). It comprised all 52 exons, intronic flanking regions, promoter and 3’UTR region of the VWF gene. Libraries were prepared by using the Twist NGS target enrichment solution (Twist BioScience) according to the manufacturer protocol. Samples were analyzed on a NovaSeq 6000 sequencer (Illumina) with a median read depth of 2500X by using the 300-cycle S1 NovaSeq 6000seq reagent kit with 150-bp paired-end reads. The raw data were analyzed with Mutect21 and Vardict2 tools. The inhouse NGSreport software (CHU Lille) was used for data visualization, sequences check and conservation of variants with high quality metrics. In some cases, patients genomic DNA was screened for sequence variations (large deletions, insertions and duplications) by Multiplex Ligation-dependent Probe Amplification (MCR Holland).

      PreviouslyPublished: NA

      Gene: VWF

      Variant: deletion of exons 9-10

      HGVS: NM_000552.5:c.1030_1317del (p.Gly344_Arg439del)

      ClinVarID:

      CAID: CA3260663889

      gnomAD:

      Variant: c.4138A > G, p.(Ile1380Val)

      HGVS: NM_000552.5:c.4138A>G (p.Ile1380Val)

      ClinVarID: 310063

      CAID: CA6402595

      gnomAD: MAF of 0.1184 (8878/74958 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6019280-T-C?dataset=gnomad_r4

      Variant: c.4304A > G, p.(Asn1435Ser)

      HGVS: NM_000552.5:c.4304A>G (p.Asn1435Ser)

      ClinVarID: 310062

      CAID: CA6402552

      gnomAD: MAF of 0.1124 (8427/74964 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6019114-T-C?dataset=gnomad_r4

      Variant: c.4414G > C p.(Asp1472His)

      HGVS: NM_000552.5:c.4414G>C (p.Asp1472His)

      ClinVarID: 256679

      CAID: CA6402534

      gnomAD: MAF of 0.5076 (38011/74882 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6019004-C-G?dataset=gnomad_r4

      Variant: c.4628C > G p.(Ser1543Cys)

      HGVS: NM_000552.5:c.4628C>G (p.Ser1543Cys)

      ClinVarID: 4533008

      CAID: CA383500651

      gnomAD:

    3. 9 F

      Case: Patient 9, Family F (Table 1.), F/76, Afro-Caribbean

      DiseaseAssertion: VWD2A (IIE)

      FamilyInfo: Patient 8 (M/86, Afro-Caribbean) and Patient 28 (F/55, Afro-Caribbean) also from Family F. (Table 1.)

      ParentalGenotype(s): NA

      CasePresentingHPOs:

      CaseHPOFreeRext: BAT =11, FVIII:C (IU/dL) = 40, VWF:Ag (IU/dL) = 30, VWF:Act (IU/dL) = 28

      CaseNOTHPOs:

      CaseNOTHPOFreeText: Blood group B-

      CasePreviousTesting:

      GenotypingMethod: All samples were analyzed by captured-based high throughput sequencing which was performed with a custom-design of the VWF gene provided by Twist BioScience (San Francisco, USA). It comprised all 52 exons, intronic flanking regions, promoter and 3’UTR region of the VWF gene. Libraries were prepared by using the Twist NGS target enrichment solution (Twist BioScience) according to the manufacturer protocol. Samples were analyzed on a NovaSeq 6000 sequencer (Illumina) with a median read depth of 2500X by using the 300-cycle S1 NovaSeq 6000seq reagent kit with 150-bp paired-end reads. The raw data were analyzed with Mutect21 and Vardict2 tools. The inhouse NGSreport software (CHU Lille) was used for data visualization, sequences check and conservation of variants with high quality metrics. In some cases, patients genomic DNA was screened for sequence variations (large deletions, insertions and duplications) by Multiplex Ligation-dependent Probe Amplification (MCR Holland).

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.1530G > A, p.(Val510 =) p.

      HGVS: NM_000552.5:c.1530G>A (p.Val510=)

      ClinVarID:

      CAID: CA6403368

      gnomAD: MAF of 0.00002198 (2/91004 alleles) in South Asian population https://gnomad.broadinstitute.org/variant/chr12-6062957-C-T?dataset=gnomad_r4

      Variant: c.1892C > T, p.(Ala631Val)

      HGVS: NM_000552.5:c.1892C>T (p.Ala631Val)

      ClinVarID: 422844

      CAID: CA6403245

      gnomAD: MAF of 0.001908 (137/71810 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6056910-G-A?dataset=gnomad_r4

      Variant: c.2220G > A, p.(Met740Ile)

      HGVS: NM_000552.5:c.2220G>A (p.Met740Ile)

      ClinVarID: 100206

      CAID: CA201316

      gnomAD: MAF of 0.1816 (13626/75022 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6046784-C-T?dataset=gnomad_r4

      Variant: c.2451T > A, p.(His817Gln)

      HGVS: NM_000552.5:c.2451T>A (p.His817Gln)

      ClinVarID: 100224

      CAID: CA228345

      gnomAD: MAF of 0.1150 (8626/75016 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6036483-A-T?dataset=gnomad_r4

      Variant: c.3426T > C, p.(Cys1142 =)

      HGVS: NM_000552.5:c.3426T>C (p.Cys1142=)

      ClinVarID: 256668

      CAID: CA6402757

      gnomAD: MAF of 0.2077 (7935/38206 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6022852-A-G?dataset=gnomad_r4

      Variant: c.3445T > C, p.(Cys1149Arg)

      HGVS: NM_000552.5:c.3445T>C (p.Cys1149Arg)

      ClinVarID: 309

      CAID: CA228410

      gnomAD: MAF of 0.000003160 (1/316464 alleles) in European (non-Finnish) population https://gnomad.broadinstitute.org/variant/chr12-6022833-A-G?dataset=gnomad_r4

      Variant: c.3485C > T, p.(Pro1162Leu)

      HGVS: NM_000552.5(VWF):c.3485C>T (p.Pro1162Leu)

      ClinVarID: 256669

      CAID: CA6402756

      gnomAD: MAF of 0.2076 (7087/34136 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6022793-G-A?dataset=gnomad_r4

      Variant: c.3486A > G, p.(Pro1162 =)

      HGVS: NM_000552.5:c.3486A>G (p.Pro1162=)

      ClinVarID: 256670

      CAID: CA6402755

      gnomAD: MAF of 0.2083 (7074/33968 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6022792-T-C?dataset=gnomad_r4

      Variant: c.4414G > C p.(Asp1472His)

      HGVS: NM_000552.5:c.4414G>C (p.Asp1472His)

      ClinVarID: 256679

      CAID: CA6402534

      gnomAD: MAF of 0.5076 (38011/74882 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6019004-C-G?dataset=gnomad_r4

      Variant: c.6554G > A, p.(Arg2185Gln)

      HGVS: NM_000552.5:c.6554G>A (p.Arg2185Gln)

      ClinVarID: 100443

      CAID: CA228748

      gnomAD: MAF of 0.1927 (14427/74878 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-5993906-C-T?dataset=gnomad_r4

    4. 45 V

      Case: Patient 45, Family V (Table 1.), M/51, Afro-Caribbean

      DiseaseAssertion: VWD2M

      FamilyInfo: NA

      ParentalGenotype(s): NA

      CasePresentingHPOs:

      CaseHPOFreeRext: BAT = 5, FVIII:C (IU/dL) = 45, VWF:Ag (IU/dL) = 96, VWF:Act (IU/dL) = 59

      CaseNOTHPOs:

      CaseNOTHPOFreeText: Blood group O+

      CasePreviousTesting:

      GenotypingMethod: All samples were analyzed by captured-based high throughput sequencing which was performed with a custom-design of the VWF gene provided by Twist BioScience (San Francisco, USA). It comprised all 52 exons, intronic flanking regions, promoter and 3’UTR region of the VWF gene. Libraries were prepared by using the Twist NGS target enrichment solution (Twist BioScience) according to the manufacturer protocol. Samples were analyzed on a NovaSeq 6000 sequencer (Illumina) with a median read depth of 2500X by using the 300-cycle S1 NovaSeq 6000seq reagent kit with 150-bp paired-end reads. The raw data were analyzed with Mutect21 and Vardict2 tools. The inhouse NGSreport software (CHU Lille) was used for data visualization, sequences check and conservation of variants with high quality metrics. In some cases, patients genomic DNA was screened for sequence variations (large deletions, insertions and duplications) by Multiplex Ligation-dependent Probe Amplification (MCR Holland).

      PreviouslyPublished: NA

      Gene: VWF

      Variant: c.4196G > A, p.(Arg1399His)

      HGVS: NM_000552.5:c.4196G>A (p.Arg1399His)

      ClinVarID: 293

      CAID: CA114133

      gnomAD: MAF of 0.01540 (456/29604 alleles) in Ashkenazi Jewish population https://gnomad.broadinstitute.org/variant/chr12-6019222-C-T?dataset=gnomad_r4

      Variant: c.4414G > C p.(Asp1472His)

      HGVS: NM_000552.5:c.4414G>C (p.Asp1472His)

      ClinVarID: 256679

      CAID: CA6402534

      gnomAD: MAF of 0.5076 (38011/74882 alleles) in African/African American population https://gnomad.broadinstitute.org/variant/chr12-6019004-C-G?dataset=gnomad_r4

    1. Case#: Elayaperumal_2018_V-260 , M, 3y.o. (onset), origin in India

      DiseaseAssertion: VWD type 3

      FamilyInfo: consanguinity reported. No family history of bleeding

      ParentalGenotype: not reported

      CasePresentingHPOs:

      CaseHPOFreeText: bleeding score of 9, VWF:Ag of 0, FVIII:C of 7.4%

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: CSGE and Sanger sequencing of VWF gene only.

      Gene: VWF

      Variant: homozygous c.665G>A (p.Trp222*)

      HGVS: NM_000552.3:c.665G>A

      ClinVarID: not found

      CAID: CA383509511

      gnomAD: not found

      MultipleGeneVariants: n/a

    2. Case#: Elayaperumal_2018_V-312 , M, 2.5 y.o. (onset), origin in India

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: Yes, Family history: No

      ParentalGenotype: not reported

      CasePresentingHPOs:

      CaseHPOFreeText: Bleeding score: 7, VWF:Ag 0, FVIII:C 3.6%

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: CSGE and Sanger sequencing of VWF gene only.

      Gene: VWF

      Variant: homozygous c.3560delT

      HGVS: NM_000552.3:c.3560delT (p.Leu1187Cysfs*28)

      ClinVarID: not present

      CAID: CA2580612141

      gnomAD: not present

      MultipleGeneVariants:

    3. Case#: Elayaperumal_2018_V-316, F, 1.5 y.o. (onset), origin in India

      DiseaseAssertion: VWD type 3

      FamilyInfo: Consanguinity: Yes, Family history: Yes

      ParentalGenotype: not reported

      CasePresentingHPOs:

      CaseHPOFreeText: Bleeding score: 0, VWF:Ag 0, FVIII:C 3.4%

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: CSGE and Sanger sequencing of VWF gene only.

      Gene: VWF

      Variant: homozygous c.2749 2752dupCCCT (p.Val919Leufs*18)

      HGVS: NM_000552.3:c.2749 2752dupCCCT

      ClinVarID: not present

      CAID: CA2695215955

      gnomAD: not present

      MultipleGeneVariants:

    1. 6-months-old

      Case: 8 years old female, age of genetic diagnosis; 6-months-old, when first presented with bilateral in-toeing

      DiseaseAssertion: related to neurological symptoms, difficult to say which type of VWD she has

      FamilyInfo: great uncle with "clubfoot"

      CasePresentingHPOs: HP:0007340, HP:0001347, HP:0001771,

      CaseHPOFreeText: Talipes equinovarus bilaterally

      Gene: VWA1

      Variant: c.62_71dup (p.Gly25ArgfsTer74)

      HGVS: NM_022834.5:c.62_71dup

      ClinVar: 830327

      gnomAD: allele frequency: 0.0003330, https://gnomad.broadinstitute.org/variant/1-1371178-T-TGGCGCGGAGC?dataset=gnomad_r2_1

    1. V‐115

      Case#: Elayaperumal_2018_V-115, female, 1 year old (onset), origin in India

      DiseaseAssertion: VWD type 3

      FamilyInfo: consanguinity

      ParentalGenotype: not reported. family history of bleeding.

      CasePresentingHPOs:

      CaseHPOFreeText: bleeding score of 13. VWF:Ag of 0. FVIII:C of 1.9%

      CaseNotHPOs:

      CaseNotHPOFreeText:

      CasePreviousTesting: not reported

      GenotypingMethod: CSGE and Sanger sequencing of VWF only.

      Gene: VWF

      Variant: homozygous c.6321G>A (p.Trp2107*)

      HGVS: NM_000552.3:c.6321G>A (p.Trp2107*)

      ClinVarID: not found

      CAID: CA383491677

      gnomAD: not found

      MultipleGeneVariants: not reported

    1. Bleeding score in Type 1 von Willebrand disease patients using the ISTH-BAT questionnaire A. Pathare, Corresponding Author A. Pathare avp16@hotmail.com orcid.org/0000-0003-3205-0611 Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, Oman Correspondence Dr. Anil Pathare, Department of Haematology, Sultan Qaboos University Hospital, Muscat, Oman. Email: avp16@hotmail.comSearch for more papers by this authorS. Al Omrani, S. Al Omrani Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, OmanSearch for more papers by this authorF. Al Hajri, F. Al Hajri Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, OmanSearch for more papers by this authorN. Al Obaidani, N. Al Obaidani Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, OmanSearch for more papers by this authorB. Al Balushi, B. Al Balushi Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, OmanSearch for more papers by this authorK. Al Falahi, K. Al Falahi Department of Haematology, College of Medicine & Health Sciences, Sultan Qaboos University Hospital, Muscat, OmanSearch for more papers by this author

      PMID: 29115727

      Gene: VWF

      HGNC: 12726 (type 1)

      Note: This article is about how the median ISTH-BAT questionnaire score for VWD type 1 was 7 (IQR; 2,11).

    1. 103< 1< 13−−18Mc.2269_2270delCT/c.2435delCp.L757VfsX22/p.P812RfsX3117/1817/18PD/PD

      Case: Patient 10, M, Hungarian

      DiseaseAssertion: VWD type 3

      FamilyInfo: compatible with recessive inheritance

      ParentalGenotype(s): n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeRext: Bleeding score: 18, VWF:Ag (IU dL−1): < 1, VWF:CB (IU dL−1): < 1, FVIII:C (IU dL−1): 3, VWF:RCo below detection limit (<10 IU dL−1), not detectable VWF on multimer gels

      CaseNOTHPOs: n/a

      CaseNOTHPOFreeText: no inhibitor detected, did not become refractory to factor replacement therapy

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2269_2270delCT (p.L757VfsX22), Exon 17

      c.2435delC (p.P812RfsX31), Exon 18

      Intron 40 VNTR: 17/18

      Note: multimer electrophoresis, Recombinant VWF antigen concentrations and Collagen binding activity (VWF:CB) measured by ELISA, direct sequencing of the 51 exons and the exon‐intron boundaries, Breakpoint analysis and breakpoint‐specific PCR

    2. 173< 1< 14−−18Fc.7333delG/c.7703C>Ap.E2445RfsX16/p.S2568X43/4517/18N/N

      Case: Patient 17, F, Hungarian

      DiseaseAssertion: VWD type 3

      FamilyInfo: compatible with recessive inheritance

      ParentalGenotype(s): n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeRext: Bleeding score: 18, VWF:Ag (IU dL−1): < 1, VWF:CB (IU dL−1): < 1, FVIII:C (IU dL−1): 4, VWF:RCo below detection limit (<10 IU dL−1), not detectable VWF on multimer gels, bleeding episode severity increased after the menarche

      CaseNOTHPOs: n/a

      CaseNOTHPOFreeText: no inhibitor detecteddid not become refractory to factor replacement therapy

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.7333delG (p.Glu2445ArgfsX16), Exon 43

      c.7703C>A (p.Ser2568X), Exon 45

      Intron 40 VNTR 17/18

      Note: multimer electrophoresis, Recombinant VWF antigen concentrations and Collagen binding activity (VWF:CB) measured by ELISA, direct sequencing of the 51 exons and the exon‐intron boundaries, Breakpoint analysis and breakpoint‐specific PCR

    3. 123117−−32Fc.2124_2125delCT/c.2124_2125delCTp.C709LfsX3/p.C709LfsX316/1618/18PD/PD

      Case: Patient 12, F, Hungarian

      DiseaseAssertion: VWD type 3

      FamilyInfo: compatible with recessive inheritance

      ParentalGenotype(s): n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeRext: Bleeding score: 32, VWF:Ag (IU dL−1): 1, VWF:CB (IU dL−1): 1, FVIII:C (IU dL−1): 7, VWF:RCo below detection limit (<10 IU dL−1), not detectable VWF on multimer gels, bleeding episode severity increased after the menarche

      CaseNOTHPOs: n/a

      CaseNOTHPOFreeText: no inhibitor detected, did not become refractory to factor replacement therapy

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2124_2125delCT (p.Cys709LeufsX3), Exon 16, Homozygous

      Intron 40 VNTR: 18/18

      Note: multimer electrophoresis, Recombinant VWF antigen concentrations and Collagen binding activity (VWF:CB) measured by ELISA, direct sequencing of the 51 exons and the exon‐intron boundaries, Breakpoint analysis and breakpoint‐specific PCR

    4. 83112−−19Mc.2435delC/c.2435delCp.P812RfsX31/p.P812RfsX3118/1819/19PD/PD

      Case: Patient 8, M, Hungarian

      DiseaseAssertion: VWD type 3

      FamilyInfo: compatible with recessive inheritance

      ParentalGenotype(s): n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeRext: Bleeding score: 19, VWF:Ag (IU dL−1): 1, VWF:CB (IU dL−1): 1, FVIII:C (IU dL−1): 2, VWF:RCo below detection limit (<10 IU dL−1), not detectable VWF on multimer gels

      CaseNOTHPOs: n/a

      CaseNOTHPOFreeText: no inhibitor detected, did not become refractory to factor replacement therapy

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.2435delC (p.Pro812ArgfsX31), Exon 18, Homozygous

      Intron 40 VNTR: 19/19

      Note: multimer electrophoresis, Recombinant VWF antigen concentrations and Collagen binding activity (VWF:CB) measured by ELISA, direct sequencing of the 51 exons and the exon‐intron boundaries, Breakpoint analysis and breakpoint‐specific PCR

    5. 15*3113−−NDFc.3379+1G>A/c.3379+1G>ASplice/Splice25/2518/18PD/PD

      Case: Patient 15, F, Hungarian

      DiseaseAssertion: VWD type 3

      FamilyInfo: compatible with recessive inheritance

      ParentalGenotype(s): n/a

      CasePresentingHPOs: n/a

      CaseHPOFreeRext: VWF:Ag (IU dL−1): 1, VWF:CB (IU dL−1): 1, FVIII:C (IU dL−1): 3, VWF:RCo below detection limit (<10 IU dL−1), not detectable VWF on multimer gels, bleeding episode severity increased after the menarche

      CaseNOTHPOs: n/a

      CaseNOTHPOFreeText: no inhibitor detected, did not become refractory to factor replacement therapy

      CasePreviousTesting: n/a

      Gene: VWF

      Variant:

      c.3379+1G>A (Splice), Exon 25, Homozygous

      (p.Arg924Gln), Exon 21, Homozygous

      Intron 40 VNTR 18/18

      Note: multimer electrophoresis, Recombinant VWF antigen concentrations and Collagen binding activity (VWF:CB) measured by ELISA, direct sequencing of the 51 exons and the exon‐intron boundaries, Breakpoint analysis and breakpoint‐specific PCR

    1. 3

      Case#: 3, female, 19yo

      DiseaseAssertion: VWD1

      FamilyInfo: brother diagnosed with VWD

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0000978; HP:0000132, HP:0004846, HP:0012147, HP:0030129 (Bruising susceptibility, Menorrhagia, Reduced quantity of VWF, Impaired ristocetin cofactor assay activity)

      CaseHPOFreeText: Type O blood, VWF:Ag (0·55–2 iu/ml) pre = 0·14, VWF:RCo (0·55–2 iu/ml) pre = 0·15, FVIII:C (0·55–2 iu/ml) pre = 0·1, FVIII:C/VWF:Ag ratio = 0·71, VWF:FVIII binding (>20%) = n/a, VWF:FVIII binding/VWF:Ag (>0·7) = n/a, spinal surgery with VWF concentrate and adequate haemostasis

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: N/A

      CasePreviousTesting: RFLP; confirmatory sequencing

      Gene: VWF

      Variant 1: NM_000552.4(VWF):c.2561G>A (p.Arg854Gln)

      ClinVar: 296; https://www.ncbi.nlm.nih.gov/clinvar/variation/296/

      gnomAD: MAF = 0.005692 (European Non-Finnish); https://gnomad.broadinstitute.org/variant/12-6143978-C-T

      Variant 2: N/A - stated to be a compound heterozygote for a 2N VWD and a presumed null mutation

    2. 4

      Case#: 4, male, 23yo

      DiseaseAssertion: VWD1

      FamilyInfo: N/A

      ParentalGenotype: N/A

      CasePresentingHPOs: HP:0004846, HP:0012147, HP:0030129 (Reduced quantity of VWF, Impaired ristocetin cofactor assay activity)

      CaseHPOFreeText: Haemarthrosis in teens, Delayed bleeding after tonsillectomy (DDAVP given prior to procedure), VWF:Ag (0·55–2 iu/ml) pre = 0·35, VWF:RCo (0·55–2 iu/ml) pre = 0·32, FVIII:C (0·55–2 iu/ml) pre = 0·12, FVIII:C/VWF:Ag ratio = 0·34, VWF:FVIII binding (>20%) = n/a, VWF:FVIII binding/VWF:Ag (>0·7) = n/a, Surgery to repair a syringomyelia defect with VWF concentrate and no bleeding complications

      CaseNotHPOs: N/A

      CaseNotHPOFreeText: N/A

      ProteinExpression: N/A

      CasePreviousTesting: RFLP; confirmatory sequencing

      Gene: VWF

      Variant 1: NM_000552.4(VWF):c.2561G>A (p.Arg854Gln)

      ClinVar: 296; https://www.ncbi.nlm.nih.gov/clinvar/variation/296/

      gnomAD: MAF = 0.005692 (European Non-Finnish); https://gnomad.broadinstitute.org/variant/12-6143978-C-T

      Variant 2: N/A - stated to be a compound heterozygote for a 2N VWD and a presumed null mutation

    1. VWD3-4‡8.3<4.05<1.0436c.319C>T§c.6151A>T§p.Gln107Terp.Arg2051TerD1D4Stop gainedStop gainedHeterozygousHeterozygous

      Case: Croatian adult patient

      DiseaseAssertion: VWD3

      FamilyInfo: No variant detected in a family member with VWD3.

      ParentalGenotype(s): Not specified

      CasePresentingHPOs: HP:0001892, HP:0011890, HP:0000132, HP:0002239, HP:0000790, HP:0001342

      CaseHPOFreeText: Reduced VWF:Ag of <4.0%, VWF:GPIbM of 8.3%, FVIII:C of 5% and VWF:CBA below 1%.

      CaseNOTHPOs: Not specified

      CaseNOTHPOFreeText: Not specified.

      CasePreviousTesting: Not reported

      GenotypingMethod: Illumina NGS, custom designed panel covering all 52 exons as well as intronic flanking regions and promoter region of VWF gene.

      PreviouslyPublished: None

      Gene: VWF

      Variant: c.6151A>T

      HGVS: NM_000552.4:c.6151A>T (c.6151A>T)

      ClinVarID: Not available

      CAID: CA383492290

      gnomAD: Not available

    2. VWD1-341.367.80.617250.5NormalExon 17c.2269_2270delCT‡p.Leu757ValfsTer22D2Frameshift indels

      Case: Croatian adult patient

      DiseaseAssertion: VWD1

      FamilyInfo: Not specified

      ParentalGenotype(s): Not specified

      CasePresentingHPOs: HP:0001892, HP:0011890, HP:0000132, HP:0002239, HP:0000790, HP:0001342

      CaseHPOFreeText: Reduced VWF:GPIbM of 41.3%. Normal VWF:Ag of 67.8%, FVIII:C of 72% and VWF:CBA of 50.5%. Normal multimer distribution.

      CaseNOTHPOs: Not specified

      CaseNOTHPOFreeText: Normal multimer size distribution (tested in Agarose gel).

      CasePreviousTesting: Not reported

      GenotypingMethod: Illumina NGS, custom designed panel covering all 52 exons as well as intronic flanking regions and promoter region of VWF gene.

      PreviouslyPublished: PMID: 34351388

      Gene: VWF

      Variant: c.2269_2270delCT

      HGVS: NM_000552.4:c.2269_2270delCT (p.Leu757ValfsTer22)

      ClinVarID: 100207

      CAID: CA228313

      **gnomAD: ** 0.000008794 in European (non-Finnish), 0.0003115 in XX and 0.0001629 in XY

      https://gnomad.broadinstitute.org/variant/12-6155899-CAG-C?dataset=gnomad_r2_1

    1. In family 1, the proposita (1A)

      Case#: 1A

      DiseaseAssertion:

      FamilyInfo: Family 1. Her 2 offspring, 1B (son) and 1C (daughter), reported minor bleeding symptoms that had not required treatment. 1B was found to be heterozygous for Trp1745Cys only and 1C was heterozygous for Arg760His only, confirming that these mutations are in trans in 1A.

      CaseHPOFreeText4: was an elderly woman with lifelong bleeding episodes, including epistaxis, ecchymosis, menorrhagia, and prolonged bleeding after dental extractions, requiring multiple medical interventions. The coexistence of both mutations appears to produce a more significant bleeding disorder as the bleeding score in 1A (8) was higher than that in either of her children (4 and 2). The position of Trp1745 in the A3 domain is shown in Figure 2. Both persons with this mutation (1A and 1B) had markedly reduced ratios of VWF collagen-binding activity to VWF antigen (CB:Ag) with type III collagen (0.1 and 0.3, respectively) and type I collagen (0.2 and 0.3, respectively). The ratio of VWF:RCo to VWF:Ag (RCo:Ag) was near unity in both persons, and VWF multimer analysis (Figure 1B) and RIPA were normal. Closure times in the PFA-100 were mildly prolonged with the ADP cartridge (1A = 173 seconds, 1B = 189 seconds, NR < 112 seconds). With the epinephrine cartridge, the closure time was prolonged in 1A only (1A = 271 seconds, 1B = 90 seconds, NR < 179 seconds).

      CasePreviousTesting: Fifty-one primer sets were used to amplify the essential regions of VWF (52 exons, flanking intronic regions, 5′ promoter region, and the 3′ untranslated region).

      Gene: VWF

      Variant: 1A demonstrated compound heterozygosity for 2 mutations in the VWF gene. The first is a novel mutation in exon 30:c.5235 G → T resulting in Trp1745Cys and the second is c.2279 G → A resulting in Arg760His.

      HGVS: NM_000552.5(VWF):c.5235G>T (p.Trp1745Cys), NM_000552.5(VWF):c.2279G>A (p.Arg760His)

      ClinVar: 100421, 31011

      CAID: CA228706, CA228316

      gnomAD: 8.474e-7 in the european non finnish pop, 0.00002669 in the African American population

    1. 55-year-old Italian man

      Case: 55-year-old Italian, male

      DiseaseAssertion: VWD, Type 2B

      FamilyInfo: Patient did not report any family history of bleeding and his daughter did not show any menorrhagia and hemorrhagic disorder. Genotyping for daughter was negative for variants of interest. Paternity of daughter established. Testing performed on both daughter and wife.

      ParentalGenotype(s): No genotyping available on parents, as they were deceased.

      CasePresentingHPOs: HP:0000421, HP:0004846, HP:0012147, HP:0030129, HP:0030130, . HP:0030132, HP:0011871, HP:0003645

      CaseHPOFreeRext: aPTT,s=45.4, Fibrinogen,mg/dL=349, VFG:Ag, IU/dL=23.4, VWF:RCo, IU/dL=8.5, VWF:CBA, IU/dL=7.2, FVIII:C, IU/dL=28.2, VWFpp, %=63.4, VWF:RCo/VWF:Ag =0.36, VWF:CBA/VWF:Ag=0.31, VWFpp/VWF:Ag=2.7, FVIII/VWF:Ag=1.2,FVIII/VWF:binding, %=127.8, ADAMTS-13 act, U/dL=110.1, Platelets, ×109/L=121-166, Hb, g/dL=8.1-15.1, Blood group= A-Rh +Rh phenotype: ccDEe Kell/Cellano phenotype: kk

      CaseNOTHPOs: none

      CaseNOTHPOFreeText: none

      CasePreviousTesting: none

      GenotypingMethod: Molecular genetic analysis of the VWF gene was performed using 3100-Avant Genetic Analyzer. Sanger-sequencing procedures were carried out to validate the identified genetic variants.

      PreviouslyPublished:

      1) PMID: 27007659

      2) PMID: 20492463

      Gene: VWF

      Variant:

      1) c.2771G>A p.R924Q, exon 21, D′D3 domain,cis heterozygous

      2) c.6532G>T p.A2178S, exon 37, cis heterozygous

      HGVS:

      1) NC_000012.12:g.6031493C>T, NC_000012.11:g.6140659C>T, NG_009072.2:g.98178G>A, NM_000552.5:c.2771G>A, NM_000552.4:c.2771G>A, NM_000552.3:c.2771G>A, XM_047429501.1:c.2771G>A, NP_000543.3:p.Arg924Gln, XP_047285457.1:p.Arg924Gln

      2) NC_000012.12:g.5993928C>A, NC_000012.12:g.5993928C>T, NC_000012.11:g.6103094C>A, NC_000012.11:g.6103094C>T, NG_009072.2:g.135743G>T, NG_009072.2:g.135743G>A, NM_000552.5:c.6532G>T, NM_000552.5:c.6532G>A, NM_000552.4:c.6532G>T, NM_000552.4:c.6532G>A, NM_000552.3:c.6532G>T, NM_000552.3:c.6532G>A, XM_047429501.1:c.6532G>T, XM_047429501.1:c.6532G>A, NP_000543.3:p.Ala2178Ser, NP_000543.3:p.Ala2178Thr, XP_047285457.1:p.Ala2178Ser, XP_047285457.1:p.Ala2178Thr

      ClinVarID:

      1) 100240

      2) 619942

      CAID:

      1) CA228368

      2) CA6401974

      gnomAD:

      1) European (non-Finnish) 0.02225 https://gnomad.broadinstitute.org/variant/12-6031493-C-T?dataset=gnomad_r4

      2) European (non-Finnish) 0.02318 https://gnomad.broadinstitute.org/variant/12-5993928-C-A?dataset=gnomad_r4

    1. homozygous c.2311A>G

      Gene:VWF

      HGNCID:12726

      Case:13 yo female

      DiseaseAssertion: Type 2N

      FamilyInfo:Fig. 1, family 2, patient 7

      ParentalGenotype(s):Unknown, obligate carriers

      CasePresentingHPOs:HP:0000421, HP:0004846, HP:0012147 HP:0030132, HP:0030130

      CaseHPOFreeRext:Oral cavity and joint bleeding, VWF:Ag 0.07 U/mL, VWF:Ac 0 U/mL, VWF:CB 0.05 U/mL, FVIII 0.04 U/mL, No VWF Multimers

      GenotypingMethod: NGS

      Gene:VWF

      Variant:c.2311A>G

      HGVS:NM_000552.5(VWF):c.2311A>G

      ClinVarID:1065273

      CAID:CA383522481

    2. homozygous c.2311A>G

      Gene:VWF

      HGNCID:12726

      Case:27 yo male

      DiseaseAssertion: Type 2N

      FamilyInfo:Fig. 1, family 1, patient 2

      ParentalGenotype(s):Unknown, obligate carriers

      CasePresentingHPOs:HP:0000421, HP:0012147 HP:0030132, HP:0030130

      CaseHPOFreeRext:Skin, oral cavity, and joint bleeding, Bleeding after tooth extractions and small wounds, VWF: Ag 0.07 U/mL, VWF:Act 0.05 U/mL, VWF:CB <0.05 U/mL, FVIII:C 0.01 U/mL, Less VWF Multimers

      GenotypingMethod: NGS

      Gene:VWF

      Variant:c.2311A>G

      HGVS:NM_000552.5(VWF):c.2311A>G

      ClinVarID:1065273

      CAID:CA383522481

    3. homozygous c.2311A>G

      Gene:VWF

      HGNCID:12726

      Case:17 yo male

      DiseaseAssertion: Type 2N

      FamilyInfo:Fig. 1, family 1, patient 3

      ParentalGenotype(s):Unknown, obligate carriers

      CasePresentingHPOs:HP:0000421, HP:0012147 HP:0030132, HP:0030130

      CaseHPOFreeRext:Oral cavity, skin, and muscle bleeding, Bleeding after tooth extractions, VWF: Ag 0.09 U/mL, VWF:Act 0.05 U/mL, VWF:CB 0.04 U/mL, FVIII:C 0.01 U/mL, No VWF Multimers

      GenotypingMethod: NGS

      Gene:VWF

      Variant:c.2311A>G

      HGVS:NM_000552.5(VWF):c.2311A>G

      ClinVarID:1065273

      CAID:CA383522481

    1. His mother also had a history of epistaxis, menorrhagia and anemia

      Case: Patient IV-4, Female (mother of proband V-2) DiseaseAssertion: Type 2A VWD, based on history of abnormal bleeding, low plasma VWF:Ag and activity, and lack of plasma HMW VWF multimers. FamilyInfo: Mother of proband V-2; part of 5-affected-member pedigree (Fig. 1). ParentalGenotype(s): Not described (her own parents' genotype status not reported in extracted text — see Figure 1). CasePresentingHPOs: HP:0000421 (Epistaxis), HP:0000132 (Menorrhagia), HP:0012147 (Reduced quantity of VWF; VWF:Ag 21.7 U/dL), HP:0030129 (Impaired VWF:RCo; VWF:Rco 5.0 U/dL), HP:0030132 (Absence of large VWF multimers — plasma), HP:0011871 (Impaired RIPA; 3.0%), HP:0003645 (Prolonged partial thromboplastin time; APTT 46.1 sec) CaseHPOFreeText: Anemia (secondary to menorrhagia; no matching HPO code in the approved list); FVIII:C not tested (N/A); TT 18.1 sec and PT 14.1 sec both within normal range. CaseNOTHPOs: NA CaseNOTHPOFreeText: Platelet VWF multimer status NOT tested for this patient ("Platelet samples were not available from IV-4") — do not assume the "normal platelet multimers" finding reported for the other four affected members applies here. CasePreviousTesting: Targeted confirmation of the familial VWF variant (not described as independent full 52-exon screening for this individual specifically); not genome-wide. GenotypingMethod: Sanger sequencing/allele-specific analysis, same platform as proband (Applied Biosystems 310 DNA analyzer). PreviouslyPublished: NA Gene: VWF Variant: Same novel heterozygous in-frame 6-bp deletion, exon 28, ΔD1529V1530 (VWF A2 domain) HGVS: c.4585_4590del (p.Asp1529_Val1530del) ClinVarID: NA CAID: NA gnomAD: NA

    2. IV-2

      Case: Patient IV-2 (daughter of III-3; first cousin of proband's mother IV-4) DiseaseAssertion: Type 2A VWD, based on low plasma VWF:Ag and activity and lack of plasma HMW VWF multimers. FamilyInfo: Daughter of III-3 (proband's granduncle); first cousin of IV-4 (proband's mother); part of 5-affected-member pedigree (Fig. 1). ParentalGenotype(s): Father (III-3) heterozygous for the variant, affected. Mother's genotype not reported. CasePresentingHPOs: HP:0012147 (Reduced quantity of VWF; VWF:Ag 30.4 U/dL), HP:0030129 (Impaired VWF:RCo; VWF:Rco 8.4 U/dL), HP:0030132 (Absence of large VWF multimers — plasma), HP:0003645 (Prolonged partial thromboplastin time; APTT 45.8 sec) CaseHPOFreeText: Described only generically as having "abnormal bleedings" / "similar clinical symptoms" — no itemized bleeding symptoms given specifically for this individual. FVIII:C 50.0 U/dL — at the exact lower limit of normal (nv 50-150), notably higher than the other affected members. RIPA not tested (N/A). TT 15.6 sec and PT 13.8 sec both within normal range. CaseNOTHPOs: NA CaseNOTHPOFreeText: Platelet-associated VWF multimers normal (HMW multimers present) per the group finding covering this patient. CasePreviousTesting: Targeted confirmation of the familial VWF variant; not genome-wide. GenotypingMethod: Sanger sequencing/allele-specific analysis, same platform as proband. PreviouslyPublished: NA Gene: VWF Variant: Same novel heterozygous in-frame 6-bp deletion, exon 28, ΔD1529V1530 (VWF A2 domain) HGVS: c.4585_4590del (p.Asp1529_Val1530del) ClinVarID: NA CAID: NA gnomAD: NA

    1. Expression studies on a novel type 2B variant of the von Willebrand factor gene (R1308L) characterized by defective collagen binding

      PMID: 16985174

      Gene: VWF

      HGNC: 12726

      Disease: von Willebrand disease type 2B

      MONDO: 0015629

      InheritancePattern: Autosomal Dominant

      Prevalence: Overall VWD prevalence is estimated to be as high as 1 in 100 in the general population, with 1 in 10,000 pursuing tertiary care referral ((PMID: 28847738).

      Penetrance: Fully penetrant / nearly fully penetrant for most pathogenic type 2 variants

    1. An apparently silent nucleotide substitution (c.7056C>T) in the von Willebrand factor gene is responsible for type 1 von Willebrand disease

      PMID: 21393328

      Gene: VWF

      HGNCID: 12726

      Case: proband (III-3 in Fig.1) is 15 year old female

      DiseaseAssertion: type 1 VWD

      FamilyInfo: Mother (II-3 in Fig.1) and grandmother (I-1) are symptomatic (moderate clinical bleeding symptoms). Father and sister asymptomatic.

      ParentalGenotype(s): mother c.7056 C>T

      CasePresentingHPOs: HP:0000421, HP:0000132, HP:0011889, HP:0000225

      CaseHPOFreeRext: mild decrease in VWF:Ag, VWF:CB and VWF:RCo. platelet VWF:Ag content was reduced. Decreased VWF multimer levels

      GenotypingMethod: Sanger sequencing, cDNA analysis

      Gene: VWF

      Variant: c.7056 C>T (affects splicing) aka c.7055_7081del

      ClinVarID: 631688

      gnomAD: AF=0.000007993 gnomAD aggregated (2/250226 alleles) https://gnomad.broadinstitute.org/variant/12-6092341-G-A?dataset=gnomad_r2_1

  3. Jul 2026
  4. Jan 2026
    1. Disease: Von-willebrand Disease (Type 1)

      Study: additional evaluation to interpret pathogenicity of a common VWF variant.

      Note: 244 healthy controls from general population to compare to the patient cohorts. Study performed with subjects from across Canada.

      Patients: 58 subjects with only the specified variant below were recruited from two cohort studies

      Variant: VWF NM_000552.5 c:4751A>G p.(Y1584C)

      According to this publication: using the rules of ACMG/AMP guidelines concluded the variant is LIKELY PATHOGENIC

      CADD score (26)

      AlphaMissense metric score (0.5865- Likely pathogenic)

      Variant identified in 14% of index cases for Canadian type 1 VWD, in ClinVar databases is shown as conflicting interpretation of pathogenicity

      Present in gnomAD, 1000 genomes, and UK BioBank with pop prevalence of 0.08%-0.27%. Highest prevalence is 0.43% in European Non-Finnish Population. Absent in East Asian and middle Eastern populations.

      Cites a VWF mouse model for this variant that shows no change in protein clearance, decreased VWF antigen levels and mild reduction in multimers.

  5. Aug 2025
    1. Disease: Von-willebrand Disease (Vicenza)

      Model organism: Mice

      Variant: VWF NM_000552.5 c:3614G>A p.(R1205H), E3 module of D3 domain

      Patient Phenotypes: enhanced VWF clearance, reduced plasma VWF:Ag ratio (Reduced half-life).

      Other substitutions at the R1205 position results in similar enhanced VWF clearance. (Cysteine and Serine) Ref DOIs: (10.1111/jth.12875) (10.1160/TH07-09-0565)

      Suggests VWF-R1205 plays a specific roles in regulating VWF clearance in vivo. They authors finding demonstrage significant conformational changes to WVF-D'D3 region. Conformational changes trigger an enhanced macrophage-mediated clearance which is most likely modulated through SR-AI and LRP1 VWF clearance receptors.

  6. Apr 2025
    1. Disease: Dystrophic epidermolysis bullosa (DEB) pruriginosa *Note: A novel vwf variant was found in this patient with these other variants in COL7A1 gene

      Patient(s): 17 YO Korean male

      Variant: VWF NM_000552.5: c.3310C>T p. (R1101W) Located in exon 26

      Hadn't been reported previously Variant found to be inherited in trans from family analysis

      According to the paper, they have classified with with ACMG guidelines as likely pathogenic.

      Reasoning: Variant absent in the Korea Ref Genome Database and Allele Freq = 0.00086% in gnomAD (Evidence: PM2)

      Variant detected in trans with another well-known pathologic variant (c.5797C>T) (Evidence: PM3)

      Multiple missense variants are known to be pathogenic in RDEB (Evidence: PP2)

      Various computational in silico predictive programs reported the variant as pathogenic (Evidence PP3)

    1. Disease: Von-willebrand Disease (Type 2A)

      Patient: 50 yo female

      Variant: VWF NM_000552.5 c:4232_4249del p.(Val411_Ile416del), Exon 28, heterozygous variant

      According to this paper, ACMG-AMP guidelines for interpreting this variant resulted in classification of likely pathogenic

      Phenotypes: increased bruising, fatigue, recurrent sinusitis, menorrhagia, neutropenia, anaemia. Reduction in high-molecular-weight multimers

      Family: segregation analysis showed two affected family members had the variant and two unaffected family members did not have variant.

      Note: Patient also has diagnosed Acute Myeloid Leukaemia (AML) NM_000546.6(TP53):c704A>G p.(Asn235Ser), listed as VUS and found by NGS

  7. Mar 2025
    1. Study: Functional study

      Model: HEK293 cell lines

      Variant: VWF NM_000552.5: c.7664C>G, p.(Pro2555Arg), described as GOF mutation

      rare missense variant, MAF = 0.00007

      RefSNP_ID:rs915754316

      Not reported in ClinVar

      Cells lines were transfected and expressed one of the following: wtVWF, p.Pro2555Arg, both variants, or a negative control variant p.Asp2509Glu

      Main result:

      p.Pro2555Arg is the first VWF GOF variant that increases platelet aggregate size (AS), which is shear-dependent and independent of fibrinogen (fb). May provide a novel risk factor for thromboembolic disease.

      Additional results:

      Variant does not affect the binding affinity of the C4 domain for BPIIb/IIIa

      VWF stem region mutations can enhance VWF's prothrombotic properties

      C4 domain of VWF may be a novel antithrombotic drug target.

  8. Feb 2025
    1. Disease: Von-willebrand Disorder (2N)

      Patient: 32 yo, male

      Variant: VWF NM_000552.5 c:2527C>T, p.(Arg760Cys), exon 17, noted to be dominant effect

      Note: Proband also has an Arg91Gln mutation in exon 20 of VWF too.

      Phenotypes: Mild bleeding history, epistaxis, bleeding gums, bleeding after tooth extraction. 11 years old had severe hemorrhage following tonsillectomy. Previous diagnosis of hemophilia A.

      Family: father has history of epistaxis but never eamined prior to study. Father has the Arg760Cys mutation at heterozygous level. Mother is asymptomatic and classified as hemophilia A carrier following hemophilia A diagnosis in son. Mother also has the Arg91Gln mutation in exon 20 at heterozygous level.

      Molecular Phenotypes: mild decrease in plasma FVIII and VWF levels, normal platelet VWF content, decreased FVIII binding capacity of VWF. Causes retention of pro-VWF(suggest defects in the maturation process of VWF). Abnormal VWF and platelet GPIb interaction(documented by impaired or absent RIPA and decreased VWF:RCo).

    1. Disease: Von-willebrand Disorder Type 2B, Noncanonical

      Patient: 55 YO, Italian male

      Note: these heterozygous variants are in cis mutations

      Variant1: VWF NM_000552.5 c.2771G>A p.(R924Q), in exon 21, D'D3 domain affected

      Variant2: VWF NM_000552.5 c.6532G>T p.(A2178S), in exon 37, D4 domain affected

      Phenotypes: Mucosal and cutaneous bleeding, low VWF antigent and VWF activity, mild thrombocytopenia, increased ristocetin-induced platelet aggregation, deficiency in high-molecular-weight multimers. Epistaxis, repeated GI bleeding, easy bruising, ISTH BAT score of 7.

      Note: Proband initially diagnosed with VWD type 1 in 2010 but later re-diagnosed as VWD-Type 2.

      Family: No reported family history of bleeding, parents unable to be included in family work-up as they were deceased by time of study. Paternity test was performed for family, parental link established. Patient's daughter does not present the same mutation noted in proband but has heterozygous polymorphic variant inherited from mother which is: VWF NM_000552.5 c.3379C>T p.(P1127S), in exon 25. Daughter did not show menorrhagia or hemorrhagic disorder except for large hematoma on the thigh after trauma of moderate intensity.

      Molecular workup: Paternity test, Sanger-sequencing to validate genetic variants, multimer analysis with electrophoresis, platelet aggregation analysis with Ristocetin, electron micrographs to observe conformation differences.

      Prediction workup: Structural analysis with I-TASSER modeling program to identify perturbed structure. A2178S is predicted as tolerated in all in-silico systems used.

      Database Information: Effect of the R924Q mutation is noted in literature database but has contradicting reports of effects altering VWF levels. Some studies do report it as a polymorphic variant

      Variant is present in dbSNP database (rs33978901). MAF in European population 0.01< MAF< 0.02

      Effect of A2178S variant is present in dbSNP database (rs34230288), MAF = 0.02 in European population.

  9. Jan 2025
    1. Disease for patient 1: Von Willebrand Disease Type1, transmitter VWD-type 3

      Disease for patient 2: Von Willebrand Disease Type 3

      Patient1: 90 YO female (Afro-Caribbean)

      Patient2: 40 YO female (Afro-Caribbean)

      Notes multiple variants in the VWF gene but have focused on variants in the D4 domain. However cannot discount the impact of some other variants.

      Variant 1: VWF NM_000552.5: c.6647del p.(Cys2216Phefs*9), results in VWF protein missing D4 domain and C-terminal end of molecule

      Phenotype patient 1: Reduced VWF levels in VWF:Ag, VWF:ristocetin cofactor, FVIII:C, FVIII(VWF:FVIIIB). Bleeding score 0, required Helixate treatment before and after receiving surgery.

      Variant 2: VWF NM_000552.5: c.6432dup p.(Pro2145Thrfs*5)

      Three sequence variations in family study showed other variants highlighted p.(Cys1149Arg) and p.(Pro2145Thrfs*5) are not on the same allele.

      Does have other variants in VWF but they are stated by authors to not be detrimental. p.(Val510=) is noted to be potentially deleterious.

      Phenotype patient 2: severely reduced VWF levels, absence of multimers, bleeding score 32, epistaxis, bruising, oral cavity bleeding, prolonged bleeding from minor wounds, menorrhagia, hemarthrosis, ankle arthropathy.

      Suggests premature termination codons in these variants may lead to NMD but that this mechanism was found to be PTC position-dependent. Degradation was not 100% and need to perform cellular experiments.

    1. Disease: Myopathic Ehlers-Danlos Syndrome (mEDS)

      Patient(s): 47 yo male, japanese descent

      Variant: COL12A1 NM_004370.6: c.395-1G>A (Homozygous variant, at splice acceptor site in exon 6, causes in-frame skipping)(located in the genomic region encoding the first von Willebrand factor A domain)

      Family: consanguineous parents with no related features of mEDS, healthy older brother

      Phenotypes (Childhood): hypotonia, weak spontaneous movements, scoliosis, torticollis, soft plams, undescended testes, motor developmental delay, slender build, triangular face, short palpebral fissures, small nose, small mouth, large ears, bilateral knee dislocations, short stature.

      Phenotypes (Adulthood): short stature, high palate, hypermobile small joints, deformed cervical spine, brachycephaly, bilateral long deformed 5th finger, severe scoliosis post surgical fixation, asymmetric pelvis

      Classification: sequencing panel found the variant and it was confirmed through sanger sequencing.

      According to ClinGenSVI recommendation: PVS1_Strong

      Applicable criteria:

      1) the one at a GT-AG 1,2 splice site

      2) the one exerting exon skipping or use of a crypic splice site that preserved the reading frame.

      3) the one at a truncated/altered region critical to protein function; was classified as PM3_Supporting (homozygous)

      Variant not registered in gnomAD (PM2_Supporting)

      Partial defect of first vWA in collagen XII judged as PS3

  10. Dec 2024
    1. Disease: Von Willebrand Disease (VWD)

      Patient(s): Found in 2 families

      Variant: VWF NM_000552.5: c.2311A>G, p.(M771V Homozygous variant in exon 18 (VWF D' domain; 8 residues down from proteolytic VWFpp furin cleavage site)

      Family: In family 1 there are 4 homozygous patients (2 male and 2 female), and one heterozygous patient (1 female). The affected females are denoted as person 1 and person 4 and the affected males are person 2 and person 3. There are three WT family members (1 female and 2 male), grandparents of these members are of unknown genotype including a daughter of an affected female and a WT male. Note here that in the family a p.R2663P variant has co-segregated with the above-mentioned variant but is not suspected to be the pathogenic driver of resulting bleeding tendency.

      In family 2 the parents of the homozygous affected male are of unknown genotype. The affected male is denoted as person 7.

      Phenotypes: Person 1- nose bleed, skin bleed, GI bleeding, oral cavity bleeds, Menorrhagia, muscle bleeding, and joint bleeding. Receives on-demand treatment for bleeding.

      Person 2-Nose bleed, skin bleed, bleeding from small wounds, oral cavity bleeds, bleeding after tooth extraction, joint bleeding. Received prophylactic treatment, reduced to on-demand treatment after a few years.

      Person 3-Nose bleed, skin bleed, oral cavity bleeds, bleeding after tooth extraction, muscle bleeding. Receives on-demand treatment for bleeding phenotype.

      Person 4- Nose bleed, bleeding from small wounds, oral cavity bleed, bleeding after tooth extraction, joint bleeding. Received prophylactic treatment that was increased after her menarche.

      Person 7- Nose bleed, oral cavity bleeds, bleeding after surgery or trauma, joint bleeding. Previously on prophylaxis, now managing bleeding with on-demand treatment.

      Note that both the p.R2663P co-segregated variant and p.M771V variant are reported in NCBI dbSNP database but functional effect not yet established.

      NGS confirmed the genotype of all study participants.

    1. Disease: Von-willebrand Disorder Type 3

      Patient: 26 yo, female

      Variant: VWF NM_000552.5 c:997+118 T>G g.(6073501 A>C), homozygous, intronic

      Phenotypes: No detectable VWF in plasma, early onset bleeding complications, epistaxis, easy bruising, bleeding following injury, menorrhagia, iron-deficient anemia

      Note: underwent prophylaxis replacement therapy, on-demand antihemorrhagic treatments, oral contraceptives, and replacement therapy.

      Family: not mentioned

      Predictions:

      VEP SpliceAI tool predicted variant likely deleterious (delta score 0.95)

      Used Polyphen-2 and SIFT which determined pathogenic likelihood.

      Neural Network Splicing, Alternative Splice Site Predictor, plug-in MaxEnt(For 5' donor site) of Human Splicing Finder all concur this variant can create a new donor splice site in intron 8. Contains premature stop codon and susceptible to NMD.

      Functional work:

      qRT-PCR performed to identify levels of VWF in IP-derived endothelial cells.

      histochemical immunostaining for IP-derived endothelial cells confirm no VWF production, only a residual amount present. Suggests leaky mutation.

      performed RNA sequencing to assess co-regulated gene networks

    1. Disease: Von-willebrand Disorder Type 2M

      Patient1: 13 YO male

      Patient2: 16 YO female

      Note they are siblings

      Variant: VWF NM_000552.5: c.5192C>T p.(Ser1731Leu), heterozygous variant, in A3 domain in exon 30

      Phenotype patient 1: several bleedings after tosillectomy, recurrent epistaxis, decreased VWF:CB ratio, decreased VWF:CB/VWF:Ag ratio

      Phenotype patient 2: menorrhagia, intermittent gum bleeding, easy bruising, decreased VWF:CB ratio, decreased VWF:CB/VWF:Ag ratio

      For both patients: VWF:CB ratio corresponds to collagen type 1, multimer analysis was normal, VWF:Ag, VWF:Ac, and factor VIII activity was normal.

      Family: Not listed

      Present in dbSNP (rs764077750)

      Present in gnomAD, rare MAF (ALL: 0.0012%)

      Predictions:

      SIFT- predicted deleterious (Score 0.01, median 3.34)

      MutationTaster- Predicted disease causing (probability score 1)

      PolyPhen2- Predicted probably damaging (Score 0.983)

      CADD score- 26.5

      Authors mention similar AA substitutions at the p.1731 position which leads to reduced binding of VWF to collagen in other patients.

      Authors also cite a functional human cell experiment in COS7 cell line which resulted in functional VWF defect.

      Authors conclude this novel variant as likely pathogenic.

  11. Nov 2024
    1. Disorder studied: Type 1 von Willebrand disease (T1-VWD).

      Type of study: Translational

      Model organism: Mouse (inbred strains) Obtained from Jackson Laboratory

      Analyses:

      VWF plasma protein quantitation (ELISA)

      Hertiability calculations

      PCR genotyping

      QTL analysis

      Allele-specific primer extension analysis

      Results:

      Identified new modifier of VWF known as (Mvwf5). Also found two loci unliked to Vwf known as (Mvwf6-7)

      Mice with this variant displayed statistically significant decrease in VWF levels, recapitulating the decreasing patterns displayed in humans.

      However, another strain of inbred mice with a different mutation did not show an age-dependent decrease in VWF. Suggests strain-specific differences in regulation of VWF levels over time.

      Mvwf5 is a cis-regulatory variant altering Vwf mRNA expression.

      This is a natural variant of the Vwf allele among inbred strains of mice. Found this variant causes elevation in steady-state levels of Vwf mRNA.

      Authors state findings show equivalent of of type 1 VWD is remarkably common in mice and humans. ALso state the Mvwf1 analysis in wild mouse populations suggest this locus is under selective pressure.

      Of the 5 potential modifier loci identified, 3 display conservation of synteny with potential human modifier loci.

    1. Disease: Platelet-type Von-willebrand Disorder (PT-VWD)

      Patient: 17 yo, male, adopted

      Variant: GP1BA NM_000173.7: c:580C>T p.(P.Leu194Phe), Heterozygous, gain-of-function

      Phenotypes: moderate bleeding phenotype, ISTH-BAT bleeding score of 3, recurrent epistaxis, easy bruising, mild thrombocytopenia

      Family: Adopted, no other family history mentioned, segregation studies not performed.

      Genetic analysis performed: found variant in GP1BA, results obtained by sanger sequencing.

      Variant present in gnomAD(rs368111193): low allele frequency, contradictory classifications

      Variant is not present in ClinVar, LOVD, or HGMD databases

      According to this paper, ACMG guidelines classified this variant as a VUS.

      This paper entered it into Clinvar (var ID 1693270)

    1. Disease: N/A, variant present in F12 gene

      Patient: 36 yo, Female, Saudi descent

      Variant:F12 NC_000005.9:g.176,830,269 G>A; p.Gly506Asp Homozygous mutation, exon 12 Located in peptidase S1 domain of F12

      Family:

      Consanguineous family history (parents first-degree cousins)

      No family history of bleeding or thrombosis

      Phenotypes:

      Significantly high activated partial thromboplastin time

      No history of bleeding during deliveries or tooth extractions

      No history of thrombosis or skin manifestations

      On no medications, physical examination unremarkable

      Factor assays and VWF tests within normal ranges except Factor XII (Severely deficient)

      variant is proposed to be deleterious but there is insufficient evidence to support this claim.

  12. Oct 2024
    1. Disease: mild haemophilia A, influencing VWF levels

      Patient: 20 yo, Female

      Variant1: F8 NM_000132.3: c.1127T>G: p. Val376Gly (Exon 8, current clinvar interpretation not available)

      Variant 2: F8 NM_000132.3: c.3780C>G: p. Asp1260Glu (Exon 14, current ClinVar interpretation is benign)

      Variant 3: VWF NM_000552.5: c.1415A>G:p.His484Arg (Exon 13, current ClinVar interpretation is Benign/likely Benign)

      Variant 4: VWF NM_000552.5: c.2365A>G:p.Thr789Ala (Exon 18, current ClinVar interpretation is Benign/ likely Benign)

      Variant 5: VWF NM_000552.5: c.2771G>A:p.Arg924Gln (Exon 21, current ClinVar interpretation is conflicting interpretations of pathogenicity (VUS-3)(Benign-4)(Likely benign-1))

      Variant 6: VWF NM_000552.5: c.4141A>G:p.Thr1381Ala (Exon 28, current ClinVar interpretation is Benign/ Likely Benign)

      Variant 7: VWF NM_000552.5: c.6532G>T:p.Ala2178Ser (Exon 37, Conflicting interpretations of pathogenicity: (VUS-1) (Likely Benign-1))

      Variant 8: F5 NM_000130.5: c.2773A>G:p.Lys925Glu (Exon 13, current ClinVar interpretation is Benign/Likely Benign)

      Variant 9: F5 NM_000130.5: c.2594A>G:p.His865Arg (Exon 13, current ClinVar interpretation is Benign/Likely Benign)

      Variant 10: F5 NM_000130.5: c.2573A>G:p.Lys858Arg (Exon 13, Conflicting interpretations of pathogenicity: (VUS-1) (Benign-2)(Likely Benign-1))

      Variant 11: F5 NM_000130.5: c.5290A>G:p.Met1764Val (Exon 16, Conflicting interpretations of pathogenicity: (VUS-1) (Benign-2)(Likely Benign-1))

      Variant 12: F13A1 NM_000129.4: c.103G>T:p.Val35Leu (Exon 2, Conflicting interpretations of pathogenicity: (VUS-1) (Benign-3))

      Variant notes: All are heterozygous

      Both variants in F8 are linked to reports associated with haemophilia, though second variant is considered benign.

      Phenotypes: History of bleeding (Heavy mentrual bleeding since menarche)(Treated with transdermal oestrogen and Levonorgestel), iron deficiency anaemia. High Janssen score for pictorial blood assessment. Gum bleeding lasting longer than 10 minutes(Treated with local application of tranexamic acid), recurrent nosebleeds, high score for ISTH and BAT assessments. Decrease in VWF:Ag ratio, VWF:CB ratio decreased, VWF: GPIbR ratio decreased

      Family: Maternal grandfather possibly haemophiliac, mother asymptomatic

    1. Disease: Von Willebrand Disease (VWD) type 1

      Patient(s): 13 yo, female and 14 yo, female, both Italian

      Variant: VWF NM_000552.5: c.820A>C p. (Thr274Pro)

      Dominant negative effect

      Heterozygous carrier

      Variant located in the D1 domain on VWF

      Phenotypes:

      heterozygous carriers have no bleeding history

      reduced VWF levels compatible with diagnosis of VWD type 1

      increased FVIII:C/VWF:Ag ratio, suggests reduced VWF synthesis/secretion as possible phathophysiological mechanism

      Normal VWFpp/VWF:Ag ratio

      Modest alteration of multimeric pattern in plasma and platelet multimers

      plasma VWF showed slight increase of LMWM and decrease of IMWM and HMWM

      Platelet VWF showed quantitative decrease of IMWM, HMWM, and UL multimers

      In silico analysis:

      SIFT, ALIGN, GVD Polyphen 2.0, SNP&GO, Mutation Taster, Pmut all suggest damaging consequences.

      PROVEAN and Effect suggest neutral effect

      according to ACMG guidelines this variant was classified as pathogenic

    1. Disease: Von-Willebrand Disorder

      Patient 2 Variant(s):

      VWF NM_000552.5: c.4135C>T p.(Arg1379Cys) Exon 28 VWF NM_000552.5: c.4130C>T p.(Ala1377Val) Exon 28 VWF NM_000552.5: c.3797C>T p.(Pro1266Leu) Exon 28 VWF NM_000552.5: c.3835G>A p.(Val1279Ile) Exon 28

      Note: Pro1266Leu and Val1279Ile are in trans with Ala1377Val and Arg1379Cys

      Note2: MAF of Ala1377Val is present in Exome Variant Server (<0.01) and 1000 Genomes database (<0.02), designated as rare variant, typically found in indiv with African ethnicity

      Family: Relatives molecular analysis showed Arg1379 and Ala1377Val variants mentioned above were in cis

      Patient 2 Phenotype: Mild bleeding symptom Nearly normal VWF:Ag value, reduced VWF:RCo value slight loss of HMWM with smear decreased/slightly decreased proteolysis Slightly reduced RIPA VWFpp/VWF:Ag ratio shows increased VWF clearance VWF platelet levels reduced reduced rBpIba binding in VWF plasma VWF:GPIbM values slightly increased

      Note: Treated with desmopressin in case of minor surgeries or delivery

      Note 2: Slightly decreased RIPA may be explained by presence of 2B New York Variant (Pro1266Leu) that mitigates RIPA assay in 2M phenotype.

      In silico analysis available:

      I-Mutant 3.0 states decrease in A1 domain stability for both mutations (Ala1377Val = -0.91, Arg1379Cys = -1.36)

      PYMOL predicts Ala1377Val does not alter formation of hydrogen bonds with Arg1374 residue and water. Predicts substitution of ARG 1379 with a cysteine results in the loss of hydrogen bonds with Lys1407 and Lys1408, predicted change in secondary structure of A1 domain

      Ala1377Val was previously reported in 3 other patients Publications:

      Millar CM, Riddel AF, Mellors G, Yee TT. The spectrum of VWD type 2 phenotypes associated with A1 domain mutations posters. J Thromb Haemost 2009; 7: 531–2.

      Logsdon BA, Dai JY, Auer PL et al. A variational Bayes discrete mixture test for rare variant association. Genet Epidemiol 2014; 38: 21–30.

      Final note: Authors suggest patients' 2M phenotype is due to the presence of Ala1377Val and Arg1379Cys together to create synergistic effect. Though difficult to discern with this specific patient having two other variants in addition to the two mentioned above.

    2. Disease: Von-willebrand Disorder, type 1

      Patient 1 Variant: VWF NM_000552.5: c.4135C>T p.(Arg1379Cys) Exon 28

      Family: History not mentioned

      Patient 1 phenotype: near normal VWF:Ag and WVF:RCo levels RIPA within normal range Platelet VWF levels were normal normal pattern for multimeric analysis of plasma Slightly reduced VWF levels

      In silico predictions available:

      I-Mutant 3.0 value = -1.36 PYMOL prediction = substitution of ARG 1379 with a cysteine results in the loss of hydrogen bonds with Lys1407 and Lys1408, predicted change in secondary structure of A1 domain

  13. Sep 2024
    1. functional assays

      Chemiluminescence assays (measuring binding capacity)

      VWF-collagen binding assay (CBA)

      Electrophoresis (Western blot)

      Bidirectional direct sequencing of PCR products

      Paternity test

      PCR and restriction assays to detect SNVs

      in vitro expression of recombinant WT and p.P1127S VWF variants in HEK293 cells

      Platelet aggregation studies

      DDAVP test

      Binding assays

      Proteolysis assays

      in silico modeling

    2. Disease: Von-willebrand Disorder

      Patient: 21 yo, female, Italian descent

      Variant: VWF NM_000552.5 c:C3379 > T p.(P1127S), homozygous

      Heterozygous and Homozygous polymorphic variant in exon 25

      Phenotypes: Bleeding Score System (BSS) = 3 minor bruising normal menstrual bleeding

      Family: (father paternity confirmed) Father suffered from rectorrhagia for rectal polyps Mother (same variant, heterozygous) has heavy menstrual bleeding, epistaxis events up to age 30, BBS= 2

      Present in dbSNP (rs139579968) MAF in European pop = 0.0001-0.0004

      Present in gnomAD, said to be present in 2 transcripts in VWF 40 alleles are present

      Predictions: listed with PolyPhen-2 and SIFT = probably damaging to protein expression/function

      CADD (score =33) and REVEL(score = 0.748) suggest deleterious effect of pathogenic variant

      I-TASSER showed large difference in 3D configuration of sequences differing by a single amino acid.

    1. Variant: VWF NM_000552.5: c.7682T>A p.(Phe2561Tyr)

      Suggested GOF mechanism

      Located in exon 45 of VWF (C4 domain)

      Present in gnomAD, suggested as likely benign/benign Found in exome and genome samples (Allele count is 69570, allele freq = 4.32e-2, homozygote count= 1725)

      Note that the assessment here is primarily in white individuals

    2. Functional outcomes:

      Among patients with recurrent Myocardial Infarction the Tyr2561-VWF variant is more common than control, particularly in younger women. (Caveat, need a larger study as this result is suggestive)

      functionally characterized Tyr2561-VWF compared with Phe2561-VWF in carriers of the respective variants by 3 static and 2 shear-based assays.

      in one static assay, using isolated GPIIb/IIIa from platelets, found no enhanced binding for rTyr2561-VWF, but a slightly enhanced binding for rTyr2561-VWF coexpressed with rPhe2561-VWF. (Caveat, cannot confirm these results by using cell-based binding assay with constitutatively GPIIb/IIIa incorporated in the cell membrane)

      In shear conditions measured by CPA, platelet aggregate size in blood of TYR2561 probands was significantly increased at all shear conditions compared to homozygous Phe2561 carriers. Using recombinant Tyr2561-VWF, confirmed specificity of the effect for VWF.

      Recombinant variant causes marked decreae in critical shear rate for collective network formation of VWF and platelets to less than 50%. complementary evidence for GOF of Tyr2561-VWF under high-shear conditions. In accordance with clinical data.

    1. Disease: Von Willebrand Disease (VWD)

      Patient: 18 yo, Male, heterozygote

      Variant: VWF NM_000552.5: c.5456_5842del p.(R1819_C1948delinsS)

      Was not present in gnomAD when searched

      Dominant negative effect

      Phenotypes:

      lower collagen-binding capacity

      History of bleeding (epistaxis)

      gum bleeding

      cutaneous bruises

      ADAMTS13 resistant

      Family: Mother, father, sister are asymptomatic

      Suggested as de novo, no picture found in patient's relative of the deletion, loss of A3 loop